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PC ExhibitA <br /> City of Qrono <br /> �rdinance Amendment I Zone Change Application <br /> $ffEe�Add/@SS: q��1# ���� <br /> Q{�/�TO 2750 Kelley Pa�icwray <br /> �"""� Y Orono,MN 58366 D�te Rece�Med ' <br /> '` � /1�1� <br /> Mein: 952-249-4800 <br /> fax 952-24&4818 �ee <br /> ,a1 Maifu�g Add�sB: ES�f'OW�&� <br /> ',� � P.O.8ox 66 <br /> � G� Crystat Bay,MN 55323-0066 Pemut Fee <br /> j���S Hoa� N�4ea <br /> Please complete. Applicant will be notified within 15 days as to the status of ths application. <br /> lncomplete applications will not be plsced on Planning Commission Agendas. <br /> SITE LOCATIOW: 3245 Wayzata Blvd W <br /> APPUCANT 1 AGENT INFORIIAATION: <br /> Narne: �akewest,LLC/Curt Frelham <br /> Phone(Prlmary): s52-93a3000 <br /> Email Address: Curtf(�lwestdev.00m <br /> Msiling Addcess: 14525 Highway T,Suite 265 City:Minnetonka ZiP: 55345 <br /> PROPERTY OWNER INFORMATION: o chedc here if property owner is seme as appllcar�t <br /> N3t11e: Lakewest,LLC 1 CuR Fretham <br /> Phone(Primary): 952-830-3000 <br /> Email Address: Curtf�lwestdev.cnm <br /> Mailing Address: 14525 Highway 7,Suite 265 City:M(Rnetonka ZIP: 55345 <br /> APPLICANTIAGENT AND/OR OWNER: <br /> • Agree to provide all informatian rBquired or reguested by the Planning Department, <br /> • AAr+ee to pay additional fees(staf�bme not covered In the�riginal fee paymerrt)as�d/or consultant e�enses incurred in <br /> review of this appiication,and <br /> • Certify that the information supplied is true and corted to the best of hisTher knowledge. The appll�xnt/agentand property <br /> owner recognlu that they ane solely responslble for submltting a complets appllcatlon being aware that upon <br /> failure to do so,the staM has no alternative but�o rsJect ft ur�l It k completiee or tc rocommend the nsquest ior <br /> deniat of the request reQardless of tts potentJ�F merit <br /> • Ac�caowledge the Es�row Agreement is completed and aigned. <br /> • The Owner hereby acknowledges and agneees to this application and further authotizes reasonable entry onto the property <br /> by City Staff, consultar�,agents,Commission and Councfl AAembers for purposes of investigatlon and veri�caUon of this <br /> request- <br /> • Owner andlor appllcant/ager�t acknowledge they must be present at at!schedukd review msetings of the Planning <br /> Commisston and Gouncll. If an appllcant and/or owner is unable to attend a scheduied rr�ting, please make <br /> errangeme�#s to have an authoriud represerstative attend In plaoe af the applicanUowner and advise the Cit�r Planner <br /> assigned to your project. <br /> _"'�_____�� <br /> App{icant/Agerrt Signature: Date: 2 <br /> Property Owner Signature: fi3ate: a <br /> _ „_,.�,.. <br /> Property Owner Sig�ature: Date: <br /> o.dfv,ence amer►a►ne►,r�zo„e change,4ppr;cet;w,— RE C E�V E D <br /> January 2016 <br /> A�2 MAR 2 3 �(1t�: <br /> � 3 � 2� cmt oF oRONo <br />