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REQUIRED SUBMITTALS: <br />All of the following information must be submitted by the application deadline date in order for your <br />application to be processed. <br />Not <br />Enclosed Applicable <br />li:V" □ Variance APPiication fee <br />□ □ Escrow Agreement signed and fee <br />□ □ Pre-Application Form <br />Iii" □ Variance APPiication Form <br />□ / □ Practical Difficulties Form <br />i;r' □ Certified Property Owners List <br />□ □ Survey (meeting ALL requirements) <br />□ □ Proposed Plans <br />□ □ Hardcover Calculations <br />□ □ Septic System Site Evaluation Report <br />□ □ Minnehaha Creek Watershed District (MCWD) Permit or <br />Documentation from MCWD stating no permit is required <br />□ □ Adjacent Property Owners ' Acknowledgement <br />□ □ Data Privacy Advisory Form <br />Ot~(.r lft,..5 1~~1uW ,~ 011 ·3,',1.r.J ctpflicct-korJ . <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 origina l 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 th at they are solely responsible for submitting a complete app lication 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 ver ification of this request. <br />• Applicant and/or Owner acknowledge they must be present at all scheduled review meetings of the <br />Planning Commission and Council. If an applicant and/or owne r is unable to attend a scheduled meeting , <br />please make arrangements to have an authorized representative attend in place of the applicanUowner and <br />advise the City Planner assigned to your project. <br />Applicant's Signature : <br />Applicant 's Signature : <br />Owner 's Signature: <br />Owner 's Signature: <br />Last Updated : January 2014 <br />7 -Zr_ r i <br />#3520 <br />lll!CEIVEO <br />JUL 22 Z014 <br />Oft'VOFORONO