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±l A <br />\r.. #1 ^(attach additional sh^ejfs 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. <br />2. <br />Co ipleted Application Form <br />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, Certificate of survey (signed by a licensed surveyor) to include <br />hardcover calculations as required (provide one (1) copy 8is"xll" for <br />reproduction). <br />5, Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy 0Ji"xll"). <br />6, Sketches or plans of floor & elevation views (provide 1 copy BJi^xll"). <br />7, _As an addendiun to this application, please attach a separate list of <br />any other 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—<^he— <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 tir-pay. addLtiowed. fees-(staff <br />time not covered by original fee payment) and/or—oon-s u 1 ta n t- .eocpen » d S <br />inourfgd- in review and certifies that the information <br />supplied is true and correct to best of his/her knowledge. <br />Applicant's Signature Date <br />OWNERS SIGNATURE ^ <br />The owner, hereby ackowledges and agrees to this application and further <br />authorizes reasonable entry onto the property by City staff, consultants, <br />agents, Coinmission members, and Council members for purposes of investiga­ <br />tion and verification of this request. <br />Owner's Signature See attached copy'_ _ ___ _ _ _ _ _ _ Date <br />Office of this change prior to the meeting.