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Aug-19-98 08:B1A Adam Smith Pr-oper-t. i es , l_LC <br />FILE No. 622 08.'19 * 93 06:44 1D:T0LD DEVELOPrtNT 612 420 7574 <br />P . 02 <br />PwGE 2 <br />A'3> <br />REQUIRED SUBMITTALS <br />1. _____ Completed Application Fonn. <br />2. ______ Describe request in detail. <br />3. _____ Cenified Property Owners List of owners within 350*, labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Depanmeni of <br />Finance, A-603, Government Center, 348-3271). <br />4. _____ Certificate of Survey (signed by a licensed surveyor) - refer to handout for survey <br />information. <br />^ Attach legal description to application if not included on required survey. <br />Topographic survey (existing and proposed contours) if land alterations involve <br />changes in elevation (grades). <br />List of the legal names (include marital status) of all persons with an interest in <br />the property. This would include name(s) of applicam(s) if not current owner(s). <br />_____ Construction plan, if applicable (sec staff for requirements). <br />_____ As an addendum to this application, please artach a separate list of any other <br />persons you wish notified of this application. <br />YOU ARE REQUIRED l O SUPPLY 30 COPIES OF LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (11” X 17'* OR SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require to scale drawings of all documents, plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. Please reiuember that your <br />application is not complete if the above information has not been included. <br />Certification by Clerical Department lhai Land Use Application is complete. <br />Initials of Clerical Staff:___________________________Date------------------------------------- <br />5. <br />6. <br />7. <br />8. <br />9. <br />APPLICANT'S SIGNATURE <br />The applicant hereby agrees to provide all information required or requested by the Zoning <br />Administrator, agrees to pay additional fees (staff time not covered by original fee payment) <br />and/or unusual expenses incurred in review of this application, and certifies that the <br />inforrnation supplied is true and correct to the best of lusher lotowlcdge. <br />Applicant's signature Date <br />mmm • ■ •• • <br />OWNER’S SIGNATURE <br />The owner hereby aclcnowlcdgcs and agrees to this application and further authorized <br />reasonable entry onto the property by City staff, consuUanw, agents, coi^isaion members, <br />and Council members for purposes of investigation and verincation of this lequesL <br />Owner's signature <br />wr <br />ir <br />iNa! <br />rril <br />1