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REQUIRED SUBMITT ALS: All of the following information must be submitted by the application deadline date in order for your application to be processed. Not Enclosed Applicable ,.er □ Variance Application Fee ,er □ Escrow Aareement, sianed and Fee z □ Pre-Application Form __.,.Er □ Variance Application Form .z □ Practical Difficulties Form ....E3 D Certified Prooertv Owners List _...a-□ Survev (meetina ALL reauirements) ...e-□ Proposed Plans Ja-D Hardcover Calculations □ □ Septic System Site Evaluation Reoort □ □ Minnehaha Creek Watershed District (MCWD) Permit or Documentation from MCWD statina no permit is reauired □ □ Adiacent Prooertv Owners Acknowledaement ~ □ Data Privacv Advisorv Form APPLICANT AND/OR OWNER: • Agree to provide all information required or requested by the Planning Department, • Agree to pay additional fees (staff time not covered in the original fee payment) and/or consultant expenses incurred in review of this application, and • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and owner recognize that they are sole ly responsible f or submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it i s complete or to recommend the request fo r denial of the request regardless of its potential merit. • Acknowledge the Escrow Agreement is completed and signed. o The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property by City Staff, consultants, agents, Commission and Council Members for purposes of investigation and verification of this request. • Applicant a nd/or Owner acknowledge they must be present at all scheduled review meetings of the Planning Commission and Council. If an applicant and/or owner is unable to attend a scheduled meeting, please make arrangements to have an authorized representative attend in place of the applicant/owner and advise the City Planner assigned to your project. . Applicant's Signature: Applicant's Signature: ------------ Owner's Signature: Owner's Signature: Packet Last Updated: Augus t 2015 Page 12 Date: Date: # 3814 RECEIVED FEB 1 7 2016 CITY OF ORONO