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(attach additional sheets if necessary) REQUIRED SUBMITTALS All of the following information must be submitted by the application deadline date in order for your application to be considered complete: 1. __ Completed Application Form 2. Certified Property Owners List of owners within 150' (you must obtain this list from Hennepin County Department of Finance A-603 Govt Center 348-3271). 3. __ Plat Map (obtained with property owners list). 4. Certificate of survey (signed by a licensed surveyor) to include --hardcover calculations as required (proyide on~ (1) copy 8½"xll" for reproduction). 5. Topographic survey (existing and proposed elevations) if any changes --in existing grade are proposed (provide one copy 8½"xll"). 6. Sketches or plans of floor & elevation views (provide 1 copy 8½"xll"). 7. As an addendum to this application, ple~se attach a separate list of any other persons you wish notified of this application. 8. __ Additional items as may be requested by City staff. The Applicant and Property Owner must sign this application. Please remember that your variance application is not complete if the above information has not been included. " ----------------------------------,------.-----' .------------------- APPLICANT'S SIGNATURE The applicant hereby agrees to provide al 1 ipf orma tion required or requested by the Zoning Administrator, agrees to pay additional fees (staff time not covered by original fee payment) and/or consultant 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~,...._,, p J /l}4,.l!t,,Lzi OWNERS SIGNATURE Date5-~¥-f3 The owner hereby ackowledges and agrees to this application and further au.thorizes reasonable entry opto the .. i,;roperty by City staff, consultants, agents, Commissipn members, .and Council members for pu-rposes of investiga- , ,. ' ' ' ~ tion and verification of this request. Owner's Signature ~ C{ c2J1~ Date $-;J.y( -f,3 -----------------------=----=------------------------------------------- Applicant must have al 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 Planl\ing 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 to advise the Building & Zoning Office of this change prior to the meeting.