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650 Big Island - 22-117-23-31-0035
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09-3425, CUP
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Project Packet
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aui,ED SUBMITTALS ' <br />' Comp le ted Application Form;.-> <br />Describe request in detail. ....-:.· <br />~ Certified Property Owne~s List of owners within 350' of the subje ct property , <br />labels and plat map . List, labels and map may be obtained from Hennepin <br />County Department of Finance, Government Center, A-603 300 South 6th <br />Street, Minneapolis, telephone 612 -348.-5910). -£ __ Certificate of Survey (signed by a licensed surveyor) -refer to handout for <br />L s1.,1rvey information. . @ Attach legal description to application if not include.don required survey. <br />_jY. ___ Topograph ic survey (ex isting · and proposed contours) if land alterations <br />involve changes in elevation (grades). , {j) _-+-List of the legal names (include marital status) of all persoos with an interest in <br />the property. This would include name(s) of appl icant(s) if not current <br />owner(s). j • ''? · <br />/8). ~_ Construction plan, if applicable (see staff for requirements) .. -h:, f>. v ,u.J ~ __ As an addendum to this application, pl ease attach a separate list of any other <br />persons you wish notified of this application. <br />YOU ARE REQUIRED TO SUPPLY 3 COPIES OF LARGE DOCUMENTS AND 1 COPY <br />FOR REPRODUCTION (11" X _17" OR SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require scaled drawings of all documents, plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. Please remember that your <br />application is not complete if the above information has not been included. <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff: _____________ Date _______ _ <br />APPLICANT'S SIGNATURE <br />The applicant hereby agrees to provid e all information required or requested by the <br />Zoning Administrator, agrees to pay additional fees (staff time not covered by original fee <br />payment) and/or unusual expenses incurred in revi ew of this application, and certifies that · <br />the information supplie ·s true nd correct to the best of his/her knowledge. <br />Applicant's signature++--,,...---,..-<'--'------------Date q; ~[1 -01 <br />OWNER'S SIGNATURE <br />The owner hereby acknowledges and agrees to this application and further authorized <br />reasonable entry onto the property by ,City staff, consultants, agents, commission <br />members, and Council members for purposes of i estigation and verification of this <br />request. <br />Owner's signatur ~ \ ,, . · v~i..:::--::;;a....,.[..f=..,.. Datee:zf:j-cCJ <br />Applicant must hav all sub ittals int the C" offi es 25 a s b fore t he P lan n in g Commissio n~ng. · / <br />Pl a nning Commiss ion Meeti gs are held on the third Monday of each mo nth. Applicants mus t be present <br />at all scheduled review meetings of the Pl annin g Commission and Co uncil. If an applicant is unable to <br />attend a scheduled meeting, please make arrangements to have a n auth o rized agent attend in your place <br />and advise the Building & Zoning Office of this change prior to th e meeting. <br />RECEIVE D <br />AUG 1 9 2009 <br />CIT Y OF ORO NO
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