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(attach additional sheets if necessary) CTTALS <br />MXX of tba folloiilao iafox3Mti.ott ■nst be sniaaLt-tad by <br />111* i <br />tba application <br />4#ltUna data in ordT for roxxx application to ba conaidarad cobd Iotas <br />I. <br />a.Coi^Iatad Application Form <br />Cartifiad Proparty 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 />_ _Certificate of survey (signed by a licensed surveyor) to include <br />hardcover calculations as required (provide one (1) copy 8*j"xll'* for <br />8. <br />reproduction ). <br />^Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy S^'x!!"). <br /><» Sketches or plans of floor t elevation views (provide 1 copy 8*j"xll*). <br />addendum to this applicatioOf please attach a separate list of <br />any other persons you wish notified of this application. <br />i*__.Addltlonal items as may be requested by City staff. <br />The Applicant and Property Owner must sign this application. Please <br />">er that yoor variance application is not contplete if the above <br />ntica has not been included. <br />WPLZCAMT'S SIGMATORE <br />®Ppiicant hereby agrees to provide all information required or <br />^e^r***®t*^ by the Zoning Administrator^ agrees to pay additional fees (staff <br />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 )cnowledge. <br />Applicant's Signature ^CJ>‘V5_v LC Date I H 0-. <br />rWIIIJ SZQU^TORB <br />The owner hereby acJcowledges and agrees to this application and further <br />authorizes reasonable entry onto the property by City staff, consultants, <br />*9®otSr Commission members, and Council members for purposes of invest!ga— <br />[ tion and verification of this request. <br />Owner's SignatursT^^Date La <br />^ Applicant must have all subr Is into the City offices 25 days before the <br />' Planning ComBd.ssion Meeting. Planning Commission Meetings are held on the <br />third Monday of each month. J^plicants must be present at all scheduled <br />i nwiew ■matiags of the Planning Conmission and Couacd.1* If an applicant is <br />MMMhle to attend a scheduled meeting, please maJce arrangements to have an <br />i aathorised agent attend in your place and to advise the Building * Zoning <br />^Office of this change prior to the meeting. <br />• * V . ' <br />■ • ■Sif . .