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ntSSZNT osz 31TY <br />Freser.t - <br />RP^- lB-1 Conferenc^^ente^ <br />“v •) <br />y <br />Present: Use cf Preperty Hesiter.tia- <br />c c r. f e r er.ee c enter <br />DESCRIPTION OP REQUEST <br />Describe request in detail:see attached <br />2. <br />required submittals <br />L CoitD X € t ed Aoo lica^^c** •c^***« ^ z r * ^ o*^*a*^ <br />Procerrv Owners -is^ c- o-----^ ^--------- ^ _________,0^- <br />this list frorr. Hennepin Countv Departr.e..- c. .-..a..-- « <br />Center 348-3271). <br />Ce’-*'•*icate of survev (sicnec a----e..se- s^-.-.c- . <br />T^Vo'c r a’p h i c s . r v , y , _e . . s -. . r. c_ ^ ,_r = p c a e = = = r. -. a . r s ...... <br />invCaive cn3-*v-es e-.wp-2- —a — —aite.aw-o..s staff fer recui rer.ent s ■. <br />Construction plan, -- a-w-.wa-----^ ^__‘a se-arate list of <br />As an addendum to tnis apc-icaticn, r-j- c-." <br />any other persons you wisr. noti.ied c. <br />3. <br />4. <br />5. <br />S. <br />7. <br />YOU ARE REQUIRED TO SUPPLY 30 COPIES OF <br />A WORKING COPY (11" X 17" OR S.MALLER) FOR <br />Ph« applicant and r“5/3tc’*eVe if'"the"aicve inforr.aticn hasrtr.«mber that your apc-ica—on -s ..o. co...------------ <br />ict been included. ______________________________________ <br />j^^2,cation by Clerica- Oepartme..- w..a- w,-..- ^-se ••^r <br />[cltials of Clerical Staff :___-------------------—-----------------— <br />1 cation is ccr.plete. <br />Date <br />APPLICANT'S SIGNATURE -«»cuired or <br />?h« applicant hereby agrees to provioe a. :*l;r(staff <br />..quested by the incurred <br />;iB. not covered by crigina. .ee •---~.a-*cn sutoliedn review of this acclicaticn, anc certi-.-s -..a- - - - - -- - <br />s true and correct to t.h^best cf his/her .<ncw,ecce. <br />pplicant's signature <br />i^besn c* —s/ne* <br />Cjli/LfA Date a3./^ <br />milZRS signature **h*s a--* ca-"* cn and further <br />he owner hereby ac)cnowledges fr'^-v “s-a^^f, consultants, <br />ttthorised reasonable "‘1®ne- *e'-s for ourooses cfcents, coarission mer.bers, anc Counc-- rne.....e.s -o- . <br />nvestigation and verification t..is rscuesw. <br />tmer's signature Date <br />hrvVlVl‘VulVi-.--j=. , <br />uthorized agent attend in your p.ace anc ac\_se w.,e b <br />Cfice of this change prior to the meeting. <br />S'* V a :_ , <br />itt St.KilW.>r, talk M .1, .