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PRESENT USE OF PROPERTY Present Zoning District /'r—Ic Present Use of Property Residential Oth eerfy) -------------------------------------- -------------------- DESCRIPTION OF REQUEST Describe request in detail: llr,rA-,r 7i-1 L1 / ----------------------------------------------------------------�--------- IRED SUBMITTALS A2. Completed Application Form. Certified Property Owners List of owners within 350' (you can obtain this list from Hennepin County Department of Finance A-603 Government Center 348-3271) ./ 3. Stamped, legal sized envelopes (#10) pre addre ed to each of the names on the above list with no return address. 5 J4. Certificate of survey. - L kAL P-7C,-Ms Topographic survey (existing and proposed contours) if land alterations involve changes in elevation (grades). Construction plan, if applicable (see staff for requirements). A, 41 Plat Map. v/$. As an addendum to this application, please attach a separate list of any other persons you wish notified of this application. --------------------------------------------------------------------------- The applicant and Property Owner must sign this application. Please remember that your application is not complete if the above information has not been included. --------------------------------------------------------------------------- Certification by Zoning Department that Land Use Application is complete. Zoning Officials Signature Date APPLICAN'T•S SIGNATURE The applicant hereby agrees to provide all information required or requested by the Zoning Administrator, agrees to pay all fees and/or unusual expenses incurred in review of this application, and certifies that the information supplied is true and correct to the best of his/her knowledge. // 3D,1j�'. Applicant's signature Date /l OWNERS SIGNATURE The owner hereby acknowledges and agrees to this application and further authorized reasonable entry onto the property by City staff, consultants, agents, commission members, and Council members for purposes of investigation and v ricfo f tb,iLrequest. Owner's s ignatur ,, .•,, '//CC p It Date // / igo Applicant must have all submittals into the City offices 25 days before the Planning Commission Meeting. Planning Commission Meetings are held on the third Monday of each month. Applicants must be present at all scheduled review meetings of the Planning Commission and Council. If an applicant is unable to attend a scheduled meeting, please make arrangements to have an authorized agent attend in your place and advise the Building & Zoning Office of this change prior to the meeting.