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RE�iJIRED SUBMRTALS: <br /> Ail of the following information must be submit#ed by the application deadline date in order for your application to <br /> be processed. <br /> EI�IV�O� d y�VaV18 1 � 4 1 r \, � �{�_ ` . t' J . . <br /> ❑ Land Use & Conditional Use Permit Fees <br /> , . � . , . <br /> �- .�,,��: `Es�i'ov�rA�r��ti� #�si 9,d'and_ '. ,, ' <br /> ❑ ❑ Pre-A fication Form <br /> � C1 ` , .��'°,`� '=. `L"�rid Use��Eo,di onal'Use�pe�rr�if A ica�n %� <br /> ❑ Certifred Pro e Owners List <br /> �=`.�1. `.''. : '$ur�ie ,. meetikt AL� �iit?�'�ents:' <br /> O Pro osed Plans <br /> � � �� � �;Hard�o��r aiGufatiori� <br /> O ❑ Se tic S stem Site Evaluation Re ort <br /> � � �f3 M�iaiieh�ha C�ek V11ate���d tMistrict(MC'IYYD}apptov�or <br /> - � `�� " ��oc�imentation f�am MG1ND si�tin�;no erix��#�is re uire� •�� � . `r` <br /> ❑ ❑ Ad�acent Pro e Owners'Acknowled ement <br /> � � � -.#oririwater`:Pall�ut�oh Pre'ven#ipn� iian � . - . . <br /> ❑ � Da#a Privac Adviso Farm <br /> APPLICANT AND/OR OWNER: <br /> • Agree to provide all information required or requested by the Planning Depactment, <br /> • Agree to pay additionaf fees (staff time not covered kn the original fee payment) and/or consultant expenses <br /> incurred in review of this application, and <br /> • Certlfy that the infortnation supplied fs true and correct to the best of his/her knowfedge. The appllcant and <br /> owner recognlze that they are solely responslble tor submftting a complete applicetlon being aware <br /> that upon failure to do so, the statf has no alternative but to reJect It untll It Is complete or to <br /> recommend ti�e request for denlal ot the request regardless of Its potentlal merlt. <br /> • AcknowEedge the Escraw F�qreement is completed and signed. <br /> • The Ow�er hereby acknowfedges and agrees to this application and fiar#her authorizes reasonable entry onto <br /> the property by City Staff, consuftanfs, agents, Commission and Council Members for purposes of <br /> investigation and verification of this request <br /> • Owner and/or AppliCant acknowiedge they must be preser�t at all scheduled review meetings of the <br /> Planning Commission and Council. If an appiicant and/or owner is unable to attend a scheduled meeting, <br /> please make arrangements to have an authorized representative atkend in place of the appticanUowner and <br /> advise the City Planner assigned to your project <br /> �� <br /> r <br /> Owne�s Signature: Date: � (.t� � � <br /> Owrter's Signature: Date: <br /> Applicant's Signature: ate: , �� �5✓ <br /> Applicant's Signature: Date: <br /> ������� <br /> Peckettastupd�red.• .�nuaryzors �� � Q Zfl1�3 <br /> Page J2 <br /> .�, � � �� �� �F ORONO <br /> ��' <br />