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ntBSENT USB OP PROPERTY <br />Present Zoning District <br />Present Use of Property Reside"tial <br />Ctr.er {specify )_ <br />tIPnOH OF RBQOBST <br />Describe request in detail: <br />IIQOZBBD SDBMITXRLS <br />List of owners withrn 350’ (you can obtain <br />tSi.from Hennepin County Department of Finance A-603 Government <br />Center 348-3271). <br />4!Certificate of survey (signed by a licensed surveyor). i-nH <br />8.Topographic survey (existing and proposed contours) 1*land <br />alterations involve changes in elevation (grades^. <br />4 Construction plan, if applicable (see staf. for requirements). ^ <br />7I As an addendum to this application, please attach a separate ^ist of <br />any other persona you wish notified of this application. <br />mov ovnrrrvvn •m STIPPLY 30 COPIES OF LARGE DOCUMENTS OR <br />A noSniea^ai^x 17* or smaller) for all _ _ <br />Thm aoolicant and Property Owner must sign this application. <br />JJlIJlSrr tharyour .ppliceticn ie not complete if the above rnformatron has <br />aot been included, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />cirtifieatIon'brciMicirDep«tment that Land Use Application is complete. <br />Initials of Clerical Staff:_ _ _ _ _ _ _ _ ___ __ _ _ _ __ _ _ _ _ _ _ _ _ _ _ __ <br />SI^applican\ hereby agrees to provide all information ^®2oi^r«^taff <br />reouastad by the Zoning Administrator, agrees to pay additional fees <br />tSa not covered by original fee payment) and/or unusual expenses incurred <br />S^evt^ orthl. ipplilatloh, and o.rti/ies that the information supplied <br />is true and correct to ^the of^is/^r Jcnow^edge._ <br />Applicant's signature ----- Date <br />SHTwne^heMby ac)cno^e*dgeslmd*^grees to this application f <br />antharlzed reasonable entry onto the property by City staff, consultants, <br />5^12?;, co^'^SloJ aembJrs, and Council members for purposes of <br />investigation and Mritt^tlon wf ^is request. <br />Ovner • s eigneture______ <br />the City offices 25 <Jay» hej"* the <br />third Monday of each month. Applicants must be <br />mblm to attend a scheduled meeting, please maAe fn^ **^Zoi?ing <br />nntborired agent attend in your place and advise the Building <br />Office of this change prior to the meeting. <br />m.»..f WV <.>Ar .1.