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!BHT DSB OP PROPERTY p ^ p <br />Present Zoning District A ^ <br />i <br />Present Use of Property Residential <br />Other (specify) <br />CRIPTIOM OP RBQUBST <br />Describe request in detail: c co^ > <br />1,^1 1U fA/ <br />JiD SOBMITTM^ <br />1. Completed Application Form. <br />2. Certified Property Owners List of owners within 350* (you can obtain <br />this list front Hennepin County Department of Finance A-603 Government <br />Center 348-3271). <br />3. Plat Map. <br />4. Certificate of survey (signed by a licensed surveyor). <br />5. Topographic survey (existing and proposed contours) if land <br />alterations involve changes in elevation (grades). <br />6. Construction plan^ if applicable (see staff for requirements). <br />7. As an addendum to this application^ please attach a separate list of <br />any other persons you wish notified of this application. <br />TOO ARB RBQOnSD TO SUPPLY 30 COPIES OP LARGB OOCUNBNTS OR___ <br />[IMG COPY (11” X 17* OR SMALLER) POR ALL DOCUMBRTS SUBMITTED. <br />The applicant and Property Owner must sign this application. Please <br />remesUber that your application is not complete if the above information has <br />not been included. <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff: Date_______________ <br />'V »•amiCAHT'S 8II <br />The applicant hereby agrees to provide all information required or <br />requested by the Zoning Administratorr agrees to pay additional fees (staff <br />time not covered by original fee payment) and/or unusual expenses incurred* <br />in review of this applicatioUf and certifies that the information supplied <br />is true and correct to the best of his/her Icnowledge. <br />A^lioant's signature <br />oest 0£ nis/ne <br />Date /Z /s9-ht <br />8I0HATURB <br />The owner hereby acknowledges and agrees to this application and further <br />authorised reasonable entry onto the property by City staff, consultants, <br />agents# commissiun members, and Council members for purposes of <br />investigation and vei^ifica^tioii} of this request. <br />Owner's signature <br />Lun <br />ve^ri Date <br />Applicant must have all submittals into the 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 />saview meetings of the Planning Commission and Council. If an applicant is <br />aa^le to attend a scheduled meeting, please SMke arrangements to have an <br />authorised agent attend in your place and advise the Building 4 Zoning <br />Office of this change prior to the meeting.