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OTHER APPLICATIONS - CONT. $250.00 Rezoning $200.00 Appeals Other - see fee schedule -------------------------------------------------------------------- PRESENT USE OF PROPERTY Present Zoning District LR-lB Present Use of Property x Residential Ot�ier (specify) --------------------------------------------------------------------------- ' DESCRIPTION OF REQUEST Describe request in detail: Install ground water heating discharge pip - for geothermal system to provide safe year-round outlet for heat pump n o Ti-T1. --------------------------------------------------------------------------- RNQUIRED SUNIMITTALS 1. Completed Application Form. 2. Certified Property Owners List of owners within 3501(you can obtain this list from Hennepin County Department of Finance A-603 Government. Cernter 348-3271) 3. Stamped, lfgal sized envelopes (A10) pre -addressed to each of the names on the above list with no return address. 4. Certificate of survey. 5. Construction plan, if applicable. 6. Plat Map. --------------------------------------------------------------------------- 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 required or requested by the Zoning Administrator, agrees to pay all fees and/or unusual expenses incurred in review of this application, and certifies that the informatior, supplied is true and correct to the best of his/her knowledge. Applicant's signature 1�.�- �'Date STD OWNERS SIGNATURE The owner he-eby acknowledges and agrees to this application and further authorised reas4,nable entry onto the property by City staff, consultants, agents, commission memb rs, and Council members for purposes of investigation and verific n of this request. i Owner's signature Date V/'e ---------------------------------------------------7�------------- Applicant must have all submittals into the City offices 25 days before the Planning Commission Meeting. Planning Commission Meetirgs are held on the third Monday of each month.