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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. _Completed Application Form <br />2. _ _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 licei.sed surveyor) to include <br />hardcover calculations as required (orovide one (1) copy 8%"xll” for <br />reproduction). <br />5. _ _Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy 8ii'*xll"). <br />6. _SJcetches or plans of floor & elevation views (provide 1 copy 8is"xll'*). <br />7. _As an addendum to this application, please attach a separate list of <br />any ;her persons you wish notified of this application. <br />8._ _Additional items as may be requested by City staff. <br />The Applicont and Property Owner must sign this application. Please <br />remember that your variMce 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, agraes to pay additional fees (staff <br />time not covered by original 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 Date / ^ ^ <br />OWNERS SIGNATURE <br />The owner hereby ackowledgcs and agrees to this application and further <br />authorizes reasonable entry onto the property by City staff, consultants, <br />agents. Commission members, and Council members for purposes of investiga- <br />t’on and verification of this request. <br />Owner’s Si'-mature Date /J2 -.2 ! ^ Z. <br />Applicant must have all submittals into tSe^ City offices 25 days before the <br />Planning Commission 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 emd 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 S Zoning <br />Office of this change prior to the meeting. <br />\