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~2/17/2003 15:05 E,51-541-0427 vJE5 SAMPSON Al-<'CH . I PAGE 02 REQUIRED SUBMITT ALS All of the followine information must be submitted l>Y tbe aJ>.Plicatioo deadline date in order for your application to be considered complete: 1. 2. 3. 4. 15&· 5. 6. 7. 8. Completed Application Form Certified Property Owners List of owners within 150', labels and plat map (you must obtain this list1 labet,s,,,~ map from Hennepin County Department .of Finance, A-603, Govt Center,"'3~8-5910). Certificate of Survey (signed by a licensed swveyor) and include hardcover calculations as required. In addition, provide one ( 1) copy 8 ½" x 11 11 for reproduction. · Topographic survey (existing and proposed elevations) if any changes· in existing grade are proposed. In addition, provide one (1) copy 8½" x 11" for reproduction. Sketches or plans of floor & elevation views (provide one (l) copy 8 ½" x 11 "). List of the legal names (include marital status) of all persons with an interest in the property. This would include name(s) of applicant(s) if not current owner(s). As an addendum to this application. please attach a separate list of any other pergons you wish notified of this application. Additional items as may be requested by City staff. The Applicant and Property Owner must sign this application: Please remember that your variance application is not complete if tlH,~ lllmve information has not been Included. APPLICANT'S SIGNATURE The applicant hereby agrees to provide all information required or requested by the Zoning Administrator, agrees to pay additional fees (staff time not covered by original fee payment) and/or consultant expenses incurred in review of this application, and certifies that the infonnation supplied is true and correct to the best of bis/her knowledge. / / Applicant's Signature ~ ~ ~ 2) ~s ~ Date d //7 / tJ 3 ~7 OWNER'S SIGNATURE The owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property by City staff, consultants; agents, Commission members. and Council members for purposes of investigation and verification of this request. Owner's Signature 3 ~~ 'li\ --~ ~ 9::5:::::-:, Applicant rnust have all submittals into the City offices 25 d s before the Planning Commission Meeting. Planning Commission Meetings are held on the third Monday of each month. Applic~nts must be prese~t 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 to advise the Building & Zoning Office of this .change prior to the meeting. 7