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REQUIRED SUBMITTALS <br />1... Completed Application Form. <br />J.K \•--Describe request in detail. <br />3. Certified Property Owners List of owners within 350', labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Department of Finance, <br />A-6,03, Government Center, 948 3271). ~ 12-3'18-.5910 <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />__ Certificate of Survey (signed by a licensed surveyor) -refer to handout for survey <br />information. · <br />__ · Attach legal description to application if not. i.qc_luded on required survey. · <br />Topographic survey (existing and proposed contours) if land alterations involve ---changes in elevation (grades). <br />___ List of the legal names (include marital status) of all persons with an interest in the <br />property. This Wot!,ld include name(s) of applicant(s) if not current owner(s). <br />___ Construction plan, if applicable (see staff for requirements). <br />As an addendum to this . application, please attach a separate list of any other ---persons you wish notified of this application. · · <br />YOU ARE REQUIRED TO SUPPLY 30 COPIES OF.LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (11" ·x .17" OR SMALLER): FOR ALL 'DOCU1\1ENTS <br />SUBMITTED. (Staff will require . to scale drawings of al( documents, plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. Please remember that your <br />application is not complete if the above information has not been included. . <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff: ____________ Date __________ _ <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 information <br />supplied is true and correct to the est of his/her knowledge. · <br />.. <br />Applicant's signature ~~~¥-/1------lo,-------Date 2-5 JOL '-( '2--- <br />0'\VNER'S SIGNATU <br />The o\mer hereby acknowle ges agrees to this application and further authorized reasonable <br />entry onto the property by City staff, consultants, agents, commission members, and Council <br />members for purposes of investigation and verification of this request. <br />X Ov.ne(s signature -;lCJ (~M'--Date / /21/c,,1.__ <br />Applicant must have all submittals into the City ortices 25 days before the Planning Commission Meeting. <br />Planning Commission Meetings are held on the third Monday of each month. Applicants must be present at all <br />scheduled review meetings of the Planning Commission and Council. If an applicant is unable to attend a <br />scheduled meeting, please make arrangements to have an authorized agent attend in your place arid advise the Buildll1g & Zonlllg O:c: of ;~:~g~~;o th:;eetin\~ 1 1 <br />.r , ·'.; ;1 }::::.::::::,; j '?j; I <br />... ,.~_, .. ._... .:..,. .. ~-... --.. ··,,/, ~-. .J ~"-11 ., t.J·· J~ ~