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REQUIRED SUBMCfTA�3: <br /> A!1 of the fF�l{owtng irtformation must be submitbed bY the apP�tion dea�ine da�e in order for your <br /> appUca�on t�be processed. . <br /> .. � . ..�. y. i S r� .v -�Mr�-r'v • . �. , c ,� ��.�-.. <br /> . .r... � _� � . . . -�.d.. i?e i a , .�.. <br /> Endo"s+es� �°►P� '` �� w� <br /> p O Variance t�n Fee <br /> :p. .� a '�: �° <br /> � � � � O, :..�f Y�fence�Form� ;���,�<��*1 �. <br /> _p J D Prsc�ic$!Di�Cx�ltles Form _ <br /> ."'. :.D . ;j a ;�: d`.P _ , :�.� �x �;..x +�-- :*� <br /> .,i F <br /> N ALL U}f�IR611�8 <br /> Pro �, ,; � ��� � <br /> .., - :� ��; Y <br /> p O Hardc�+ret Ca�culations <br /> , - .. ..tic• :8ifQ --�,: , : �. , _ -�- <br /> .p' . � �Minnehsha�rodc Wete�ahed OI�tAot(MCWD)Psrmk or'`j <br /> Do�cumeMa�on irom MCWD no fa <br /> -`p., ~.ti� •Z ,f14i- �{y�. ' . ,sHs•...� . <br /> •' D � �:-� � pMa qdybp Folm <br /> APPLICANT ANDIOR 01NNER: <br /> • l�ree to pro�vide a6lntormafion rec�dred or reque�tad by 1he Piaru�itt0 Deperbne�� <br /> . Agrae to pey addltio�d fees(at�df�me not ooverod in the ariph�d fee PaYmeM}sndJar oonsultant expsnses <br /> hyaxred in rsvie�►of itds mpp�fCatlon,end <br /> . CeN(y thet the iMon�ta�ton suppNed is true a�d oomed b b1e best of!�lher�dDs. Ttw applica�a�td <br /> awn�r rsoognhos th�tt thsy ars solsly rrsponsibfe for submlttlng a compfsle applie�tion belr�swari <br /> tf� upon faQw+e � do so� �ho shif hes no altemeidw but bo raject it untll it.is aomp[ati� or bo <br /> �o�eoenmsnd ti�e raQu�at Tor ebnlet of d�nquett r+��aMlsss of Its�sl merit. <br /> . A�tta Esc�r A�reart�erit la mmpl�tied and.e3gned. <br /> • The�hs�sby acknowbdgea snd sAraas to tWs e�c�dor►and R�ttlet en�tlw�reae0�able er►try Ont� <br /> the Property by Clty Stedf c�r�nts� �ersts, C.orrKni�sion and Couttdl Men�bers for purpos�es a� <br /> lmrestl�atic�n and veciNcation ot!Me request. . <br /> . Appth�mt s�ruUcr �rner�ckno�rledg�they must ba pns�nt at all sohadtrl�d raview meattrtps M tfie <br /> Pla�ning Cotn�nhasbn and Cvunail. If an ep�tt o�ownsr i�unaWe b atte�d e�eduEsd me�tinQ. <br /> pleess madc�arrs�ngen�er�so have en auth re tatMe ettend in phce ot!��t►own�r and <br /> adv�se tl�e Clty Platmer�10 ' <br /> Applfoe�s 3igt�atune: � Dat9: /Z> � <br /> App�canYs Signadaro: Date: <br /> owner's�I±�nah�+�e: Dete: �p �Z a/�� <br /> o,�r$s��.: � o�: 1 o I ao (��— <br /> �r.��: A���S R�CEIVED <br /> �- . <br /> �CT z''-.i 20�� <br /> , <br /> ��oRo�o , 37 �� .: <br /> # <br />