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--•• -- •-- •------ � nu� ua <br /> FROM :HICKORY FINE HOMES BQHLRND DEU FAX ND. :9524732106 Apr. 19 2066 10:08PM P3 <br /> . � t��QU1RED SU�M17"1'Ai�3. � <br /> All df#h� fpllpwing lnformatlon must �e subm�ted by#he appli��#'r�n d��diin�dAt$ in ord�r f�r yaur <br /> applicatian ta b�processad. � <br /> � Pre�Appll�afior��I��ting F�rrr�, aQmpf�t�d by a�fkY Planner. . <br /> f� Complefad Applfr,�tia� �orm <br /> , 1� C�mpf�#ad I��rdsF�{p aacumentaf�on �orm <br /> Ct Certified Pr�perty c�wner� l.ist��wners wlthln 15p'�f th�$ubJe�t prop�r#y, l�I��I�and p�at map. <br /> LisC, lebols and map may b� obt�i�ed �frpm Her�ne�in County Department of �inan�s, <br /> �avernm�t�t Center,��603 3bd Soutii ��h�tr�et, Minneapolis, tefephone 812•�48-5910 <br /> ❑ Orf�in�l C�rti�cat� of Survey (signed by � li�ensed suryeyDr), m�efing �If th� r�quiremenks <br /> ll�toei wJthfn this pa�k�fi, in�i��ing hdrdoover calculatlans. afso provid�.one copy 8.5" x i 1° or <br /> �i"x 17"f�r r�prvdu�tion. ' <br /> � �3 � Ct�mplet�d h�rdcover calculatfan worksh�ets(��pr�vi��d W113�in fihe v�rlarrr,e �aecket), <br /> L� T0�30�1'�plliC SUNey »� including exi�tir�� arrd prapose� �levatians, and prQpQSed grading and <br /> draii�age, "�or IakeshorE prap�rties ffia con�purs �hould be shawn extendin� 5D' in#a the <br /> �dja�ent pr4perfles. Provi�e one a�py�,�"x�1"or�1"x 17"for repraduckian. <br /> � �ket�h�or plans of floor and�fevafion views{p�avfde arre�pY 8.5"x 1�"or 11"x 1�"j. <br /> A Add9ttona!item$m�y be requesfed by C►ty�t�ff dapandin�on th�sa�p�of th�p��jQCt. � <br /> A�1�1'Ll�ANT'3 A�F�M4Wf��1�GEM�NT; � - <br /> �'h� appl�cant hareby agraes ko pravide �II ln{�rmatl�n requir�d or r��u�est�d by tt�� F'l�nrring <br /> t��p�rtment, agr��s to p�y add(tiona)i�e�$(sfaff#it�e r�Qt �overed in the arl�inal �ee payrrtent) and/ar <br /> cansultanf expen���iriGUrred(r1+�qviQw aP thl�ap.pli�tiQn�nd�r�i��s that t�e tntormatl4n�uppliad is <br /> t�,l��nd cot�cE tp the�est of hislher knowl�d�e, �`he epp(tCant r�cognl�+c� �h�# h�l�hg is sal�ly <br /> r�+spansihl�ft�r��bmit�ln�a camplat�appli�atior� be{ng awa►�e tha�t upan fa4tur�ta da so,the <br /> sta�F has r�a �i�em�ative but �a re��at i# �r�tfl it I� oampl�t� ��r �a re�onnm�nd t�re t+sq�te►�� �or <br /> cf�r��a�E af tha r�que�t reg�rttls�s of it�pa�rt�fal merit. <br />---�. .. _ �PP1ic:�t�#'s�Igr�ature: �--�� � I�ate. �9 O.� F. ._ <br /> � Applic�rit's Sl�nafure: �4.�-1c-�.��� t-���'Vc� Date; �_�-..,�.. <br /> �11AIN�Ryg ACKMQWLE[7�ENl�N7't <br /> ��, �Wnsr t�ereby ��knowled�es and agre�s f4 this appli�atinrl �nd furth�r �t�thorf��s r�asona�le <br /> �ntry onta �h� �rQp�tf�l by Cify 5taff, cor►�ul�ants, agents, �ommissiort � Gouna(f M�mbers fiar <br /> pu�����f inv�stlgatia •�'�id verif+d tipn o thls r�queat � <br /> � � �� ��� d� <br /> � t�+nrhpr$$�gnatur�; �� �a�e: � <br /> �wr�er's S;�nature� .W� '�"� ��t�: 0� <br /> Appf�a�t# r��$t ttave alf su�r�t#�I� lnta the Cify o�iee$ �� �l�y� ��fpre the Planning Carnmiss(Qn <br /> Mee�ting. Plartnir�g C�mmissiK�n M�etin�s are normal{y h�ld on #he thirct Monday of eaclt mot�th. <br /> AppllCdr�t� mtfat b�present�t�!I��h�clul,�d r�vl�w me�fln�s+�f th� Rianr�in� Comtni�sian �nc( <br /> - Cbr�r��lt. iF �r� �ppllaank i$ ��k�f� �o $itend a sohedUl9d t11ep#Ing, pleas� make art�nggm�nt5 to <br /> have �;n �uthqt�z�d �a�r���ntair'nr� a�k�r�d� in pl�cQ of ti�e applipant �r�d advise th� Gity Planrier <br /> �s�igne�to your prva�ct. <br /> . , . ,:s�. ., - ,;� .����::�: <br /> ,= .a�f <br /> r . .. � ;;� `�. �..a.1�!a <br /> . . . ., ti. , ',� <br />