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(attach additional sheets if necessary) <br />REQUIRED SUBMITTALS <br />All of the following information must be submitted by the application <br />deadline date in order for your application to be considered complete; <br />1. )C Completed Application Form <br />2. V Certified Property Owners List of owners within 150' (you must obtain <br />this list from Hennepin County Department of Finance A-603 Govt Center <br />348-3271). <br />3. Plat Map (obtained with property owners list). <br />4. X Ce^ttificate of survey (signed by a 1 ■ censed surveyor) to include <br />hardcover calculations as required (provide one (1) copy 8J5"xll" for <br />reproduction). <br />5. ^ Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy 8*s"xll"). <br />6. )CS)cetches or plans of floor & elevation views (provide 1 copy 8%"xll"), <br />7. _As an addendum to this application, please attach a separate list of <br />any othe.. persons you wish notified of this application. <br />8. _Additional items as may be requested by City staff. <br />The Applicant and Property Owner must sign this application. Please <br />remember that your variance application is not complete if the above <br />information has not been included. <br />APPLICANT'S SIGNATURE <br />The applicant hereby agrees to provide all information required or <br />requested by the Zoning Administrator, agrees to pay additional fees (staff <br />time not covered by oriainal fee payment) and/or consultant expenses <br />incurred in review of this application, and certifies that the information <br />supplied is true and correct to the best of his/her knowledge. <br />Applicant's Signature ^ 0 2<T^ Date <br />OWNERS SIGNATURE <br />The owni.r nereby ackowledges Agrees to this application and further <br />authorizes reasonable entry onto che property by City staff, consultants, <br />agents. Commission members, an Council members for purposes of investiga­ <br />tion and verification of this request. <br />Owner's Signature /^Aji iSr2<,%o^ Date i? " <br />Applicant must have all submittals into the City offices 25 days before the <br />Planning Comirission Meeting. Planning Commission Meetings are held on the <br />third Monday of each month. Applicants must be present at all scheduled <br />review meetings of the Planning Commission and Council. If an applicant is <br />unable to attend a scheduled meeting, please make arrangements to have an <br />authorized agent attend in your place and to advise the Building & Zoning <br />Office of this change prior to the meeting.