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PRESENT USE OF PROPERTY Present Zoning District Present Use of Property L- Residential Other (specify) ---------------------------------------------------------------------------- DESCRIPTION OF REQUEST 11 1 Describe request in detail: / L.4 w, Lt f ti ---------T------------------------------------------------------------------ REQUIRED SUBMITTALS 1. Completed Application Form. 2. 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. Plat Map. 4. Certificate of survey (signed by a licensed surveyor). 5. Topographic survey (existing and proposed contours) if and alterations involve changes in elevation (grades). 6. Construction plan, if applicable (see staff for requirements). 7. As an addendum to this application, please attach a separate list of any other persons you wish notified of this application. YOU ARE REQUIRED TO SUPPLY 30 COPIES OF LARGE DOCUMENTS OR A WORKING COPY (11" X 17. OR SMALLER) FOR ALL DOCUMENTS SUBMITTED. --------------------------------------------------------------------------- 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 Clerical Department that Land Use Application is complete. Initials of Clerical Staff: Date --------------------------------------------------------------------------- APPLICANT'S SIGNATURE The applicant hereby agrees to provide all information required or requested by the Zoning Administrator, agrees to pav additional fees (staff time not covered by original fee payment) and/or unusual expenses incurred in review of this application, and certifies that the information supplied is true and correct to _ne best of his/her knowledge. Applicant's signature �._:, = ,r t,1 Date 5k f `1 OWNERS SIGNATURE The owner hereby acknowledges and agrees to this application and further authorized reasonable Pntry onto the property by City staff, consultants, agents, co;;imission members, and Council members for purposes of ir-�estigatiois and verification of this request. Owner's signature Date --------------------------------------------------------------------------- Applicant must '.lave 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 al I 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 i Zoning Office of this change prior to the meeting.