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S S <br /> REQUIRED SUBMITTALS: <br /> All of the following information must be submitted by the application deadline date in order for your application to <br /> be processed. <br /> Not <br /> Enclosed Applicable <br /> ❑ ❑ Escrow Agreement(signed) <br /> ❑ 0 Escrow(received) <br /> ❑ ❑ Pre-Application Form <br /> 12 ❑ Application Form <br /> ( ❑ Certified Property Owners List(350'), labels and map <br /> ❑ 0 Survey(meeting ALL requirements) <br /> ❑ 0 Proposed Plans <br /> ❑ ❑ Hardcover Calculation(s) <br /> ❑ ❑ Septic System Site Evaluation Report <br /> ❑ ❑ Wetland Delineation <br /> ❑ ❑ Wetland Buffer Evaluation <br /> ❑ 0 Buffer Improvement Plan <br /> ❑ ❑ <br /> ❑ ❑ <br /> APPLICANT AND/OR OWNER: <br /> • Agree to provide all information required or requested by the Planning Department, <br /> • Agree to pay additional fees (staff time not covered in the original fee payment) and/or consultant expenses <br /> incurred in review of this application, and <br /> • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and <br /> owner recognize that they are solely responsible for submitting a complete application being aware <br /> that upon failure to do so, the staff has no alternative but to reject it until it is complete or to <br /> recommend the request for denial of the request regardless of its potential merit. <br /> • Acknowledge the Escrow Agreement is completed and signed. <br /> • The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto <br /> the property by City Staff, consultants, agents, Commission and Council Members for purposes of <br /> investigation and verification of this request. <br /> • Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the <br /> Planning Commission and Council. If an applicant and/or owner is unable to attend a scheduled meeting, <br /> please make arrangements to have an authorized representative attend in place of the applicant/owner and <br /> advise the City Planner assigned to your project. <br /> Owner's Signature: L" `) L -f r Date: 7/1 r <br /> Owner's Signature: Date: <br /> c60.9e .e'v- P((len C / <br /> Applicant's Signature: Date: 1/i 7/ ► 3 <br /> Applicant's Signature Date: <br /> 1 U RECEIVED <br /> ,AUL 17 AM <br /> c 6 15161(.1:6 <br /> Packet Last Updated: 03/29/13 <br /> Page 13 of 29 # 362 4 <br />