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REQUfRED SUBMITTALS:
<br /> All of the following information must be submitted by 4he applica'tion deadline date in order for your •
<br /> application to be processed.
<br /> F;, �'��.. '�="`F ' Not� , - -. .. _
<br /> o;Enclosed A licable., � ,_ �
<br /> .<. ,.. .. . _ _. ,._.,, . ,.
<br /> ❑ ❑ Escrow A reement si ned
<br /> ;;.;:�.. '� ' = ❑ �Escrow received . , . , .�. � . �
<br /> ❑ ❑ Pre-A lication Form
<br /> :� ,,�,.�0�,.,. �..: ., .:, ,:0.;.. _ ;A .lication F,occn . ;
<br /> ❑ ❑ Hardshi Documentation
<br /> °� 0,;" ..-; O�: ;,'Certified'P�o � Owners:List -
<br /> .. , ..,. . :
<br /> ❑ ❑ Surve meetin ALL re uirements shown on a es 5- 6
<br /> ;� :: � ,;< ❑;k,_, �. 'Prd_o§ed,Plans
<br /> ❑ � Hardcover Calculation s
<br /> =' . 0 , �_ �. Se tic S stem Site Evafuation Re ort . _
<br /> ❑ ❑ Wetland Delineation
<br /> :;: ,, O';;.". Nd _: ,. �. ❑,�:: .. . : Wetland�Buffer,Eval.uation. . �..., � ; : ._,.;., .. : :�:.. �.. �.r��,> .
<br /> � � Buffer Im rovement Plan -
<br /> ... ❑ �. ' ',p ., __
<br /> � �,. . .
<br /> APPLICANT AND/OR OWNER:
<br /> • Agree to pro�ide all infonnation required or requested by the Planning Depa�tment,
<br /> • Agree to pay additional fees (staff time not covered in the original fee payment) and/or consultant expenses
<br /> incurred in review of this application, and
<br /> • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and
<br /> owner recognize that they are solely responsible for submitting a complete application being aware
<br /> that upon failure to do so, the staff has no alternative but to reject it until it is complete or to
<br /> recommend the request for denia(of the request regardless of its potential merit.
<br /> • Acknowledge the Escrow Agreement is completed and signed. .
<br /> • The Owner hereby acknowledges and agrees to this application and fu�ther authorizes reasonable entry onto
<br /> the property by City Staff, consultants, agents, Commission and Council Members for purposes of
<br /> investigation and verification of this request.
<br /> • Applicant andlor Owner acknowledge they must be present at all scheduled review meetings of the
<br /> Planning Commission and Council. tf an applicant and/or owner is unable to attend a scheduled meeting, �
<br /> please make arrangements to have an authorized representative attend in place of the applicanUowner and
<br /> advise the City Planner assigned to your project.
<br /> • Some or all of the information that you are asked to provide on this application is classified by State law as
<br /> either private or confidential. Private data is information which generally cannot be given to the public but can
<br /> be given to the subject of the data. Confidential data is information which generally cannot be given to either
<br /> the public or the subject of the data. Our purpose and intended use of this information is to annually update
<br /> our records and records of other governmental agencies required by law. {f you refuse to supply the
<br /> information,the a lication ma not be issued.
<br /> Applicant's Signature: � �`, ' Date: ,s�. �3 � / �
<br /> Applicant's Signature: Date:
<br /> Owner's Signature: ,,e,t���T,�ate: �. ` 3 � / �
<br /> Owner's Signature: Date: �
<br /> Last Updated� 10I16I2009 ��������
<br /> . MAY i 4 ��i�
<br /> . ci�r oF oRONo
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