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REQUIRED SUBMITTAL$ 1. _:!_ Completed Application Form. 2. _L_ Describe request in detail r (_~ee o.."'(o..ch.ecl] 3 . ____£__ Certified Property Owners List of owners within 350' of the subject property , labels and plat map . List , labels and map may be obtained from Hennepin County Department of Finance , Government Center, A-603 300 South 6th Street, Minneapolis , t~boge 61 ~-348-?:§_10 ),. ✓ Certificate of Survey (signed by a licensed surveyor) -refer to handout for suryey information . f' cJ 4. 5. 6. 7. ~ 9 . _:L__ Attach legal description to application if not included on required survey . ._ q-. rovJ +ei ~e._ V A('F+r c> ---3L..._ Topograph ic survey (exist ing and proposed contours) if land alterations involve changes in elevation (grades ). 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). Construction plan, if applicable (see staff for requirements). 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 3 COPIES OF LARGE DOCUMENTS AND 1 COPY FOR REPRODUCTION (11" X 17" OR SMALLER) FOR ALL DOCUMENTS SUBMITTED. (Staff will require scaled drawings of all documents , plans , etc . to be 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 . APPLICANT'S SIGNATURE The applicant hereby agrees to provide all information requ ired or requested by the Zoning Administrator, agrees to pay additional fees (staff time not covered by or iginal fee payment) 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 . Applicant's signature____.~~:,<-~---'---"'---------Date /!) -!'(a -Of OWNER'S SIGNATURE The owner hereby acknowledges and agrees to this application and further authorized reasonable entry onto the property by City staff, consultants , agents , commiss ion members , and Council members for purposes of investigation and verification of this request. Owner's signature_.....,....+=~~----------Date / () -I b -07 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 . CUP and Other Land Use Appl ications Last Updated : May 22 , 2009 9 343 3 RECEIVE D OCT 2 O 200 9 CITY OF ORONO