05-16-2011 Planning Commission Packet

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Apr 2011 09;47a � Pelican Bay Pack&Ship 239-325-8534 p,3 � REQUIRED SUBMITTALS: A�I of the foUowing infarrnation must be submitted by the application deadtine date in order for your application to be processed. Not Enclosed A licable ❑ � Esa-ow A reemerrt si ned � 0 Escrow received ' � ❑ Pre-fi lication Form ❑ Q A lication Farm ❑ a Hardshi Dxumentation ❑ Ci Certified Pro e Qv�mers �ist � Surue meetin AlL re uirements shown on a es 5-6 � 0 Pro ed Plans ❑ ■ Hardcover Calculation s � � Se ic S sfem Si�e Evalu�tion Re rt � i� Wetland Delineafion � '� WeUand BufFer Evaluation ❑ � Buffer Im rovement Plan ❑ ❑ � APPUCANT AND/OR OWNER: Agree ta provide alE information required or requested by the Planning Depa�tmerrt, Agree to pay additional fees (staff time not covered in the originai fee payment} andlor consultant expenses incurred in review of this applicafion, and Certify ihat the information supplied is true and correct to the best oF his/her knawlsdge. Tite app[ic�nt and ovvner recognize that they are sotely responsif�le for submiiteng a complete application 6eing aware t�at upon iailure to da so, the steff has no eltemative but to reject it until it is �ornplete or to recommerid the request for cS�niel of the request regardless of its potential mer�t. Acknowledge the Escrow Agreement is completed and signed. � The Owner hereby acknowkedges and agrees to this application and furtF�er euthorizes teasonable eniry orrto the property by City Staff, consultants, agenis, Commission and Council Members for purposes of investigation and verification of this request. � Applicant and/or Owner acknowledge ihey musi be present at all scheduled revlew meetings of the Planning Commission and Council. If an applicant andlor owner is unable to attend a scheduled meettng, please make arrangerrtents to have an authorized representative attend in place of the applicant/owner and + advise the City Planner assigned to your projeci, Some or all of the ir�forma#ion that you are asked to prflvide on tF�is application is classified by State law as either private or confidential. Privafe data is information which generally cannat be given io the public but can be giveR to the subject of the data. Confidential data is infarmaEion which generally cannot be giuen to either the publ€c or the subject of the data. Our purpose and intended use af this informatlon is to annuaUy upcfate �ur records and records of other guvemmental agencies required by law. If you refuse to supply the information,the applicatio�may not be issued. Appiicant's Signature: r a D�te: G�-/�_,� �, �� App�icant's Signature: .(�« Date: p�r-_��,�� Owne�'s Signature: 'f � ' �i . Date: a�-/% - �� Owner's Signature: Date: _ o,¢_ �9 -� ori �� -�- �-�-�- G��..�.�c�..� �-� � � ,, '°� �1�.�,�. �-�--� d�� -i'� � - 14- � � �� .