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Mar 4 '96 14;16 P.0'2/02
<br />REQU!RED StJBMJTTAU
<br />1. _ Completed Applieadoo. form.
<br />2. _ Describe rcquost m detail,
<br />3. __ Certified Pl'opmy OWZMn List of o~ withh1 350', labtls and plat map (you
<br />m!Jd obwn this !isc, i.bele Md map from Hmnepiu County Depumae111t of
<br />Finance, A--603, GDvenmient Center, 348-3271).
<br />4. _ Cem1icate of S'IJt'Ye.)' (Biped by 11 1icemed survqar) • ttfer 1.o hmiout for S1.1tYey
<br />Information. ·. , ,
<br />s. ...:.__ Attactl lepl decmiption to application if not i.Dcluded on NqUiNd survey,
<br />G. _ Topographic fNfWY (~ Md proposed coo.toes) if land alteration# ~volve
<br />eba.ngcs ill ~levatiol\ (pad.es).
<br />7, _ List of the lepl riamcs (mclude marital statua) of all pmoes 'With • interest iD
<br />die prop:rty. This would slude name(s) of applktnt(s) if not CUtffllt owner(s).
<br />8. _ Coutruction plm.. if applicable {see staff for ~).
<br />9. _ As 111 addendum. to this application, pl•e attach a sepante list ot ;any other
<br />persons you wish notified of this application. ·
<br />YOU A.RE R£Ql.1Ut£D TO SlJPPLY 30 COPIES or LARGE DOCUMENTS OR COPY
<br />FOR REPRODUCTION (11 n X 17', OR SMALLER) FOR ALL DOCUMENTS
<br />SUBMlTJtD. (Staff will n=qum; to scale dn.winp of all doo.lm.ents, plans. etc. to be
<br />submitt~.)
<br />The Applicant and Propo,ty Owner m~t sign this application.· Plwe rem~bc · that you:
<br />applic.tion is not eompletc if the abow imomumon has net been included .. : . · ·, ...
<br />•,.' !", .
<br />Certification by Clerieal Dopartm.ent chat Land Use Applicstion is complete.
<br />Initials of Clerical Std£: · · · Date ---------. ;, .'• .. ·,. , .. :,,, ... ',• ·,,·.
<br />APPLICANT'S SIGNATtJRE · · , ;. . . . . .
<br />The appli~t hereby qrees to provide -11 mfamwion requiied or teq\:fflcd by the Zoning
<br />Admirustntor. ~ to pay.additioaal fees (staff time.not eovered by original fee payment}
<br />and/or lmusual e,a,eme1,,,;m=red in review of • application. and cett:ifies , that the
<br />illlormotiOII a,pplled is and ~ lo 1b.o . r llWber ~ __ --,>
<br />Applicant's signature ~,,.,.,,..,,~ .. 11u., · · · Date '.rk/_·.31_ tJ{,
<br />OWNER'S SIGNATURE . .. ··. · .. . . . ... ,
<br />The owner ~by adc.Dowledges arad aarees to this ~pplication. ud fiutber', .authorized.
<br />reasonable mtry onto the property by City sea« ~wtau •. tgeats, eominissi"ti meaiben,
<br />and CoU!ldl members for pmposes of mvettiJati<>n and verification of this req~ ·
<br />Owu<(• ~ _ l:JJ. 8~-k~I>~ /f#A/'.:5:11%
<br />Appli'o31lt &11St law all sublbi«tall 1-o die City offim 2$ da)'I bef'o.-e t1te P~g Comaistian' M._, ·
<br />l'Jan:ll!Ag Commimon M~ .. held Oft. au thinf. Monday of C1lC'4 montb. AppUcaaa ID\U:t be pment Id
<br />all tcheduled nview ~ of the ,.... Com!71illiOI\ Uld Cmmcil. If 11D -.ipHCIIII i.l •bit to ~sud •
<br />scbedldcd ~ -pJease .--orrugmanm to have 111 a~ ~t 1111.timd i.c YN' plat@ l:lld adviae the , . '.
<br />Bulkliq &. 1.0ftin.s Offloe of 1his Gbaftp priOr to the flltetizlg. , : ::. . · . ·;,. t ; ~-. : .
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<br />LWDW 1\;i1ld\;i0 MOlSNlM Sl:Sl 301 96-90-t!\iW
<br />SO 'd
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