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i � X 7 <br /> REQUIRED SUBMITTALS: <br /> All of the following information must be submitted by the application deadline date in order for your <br /> application to be processed. ;�� . <br /> ,;� ; � .- �Not � ° ' ' ` ' f. ... <br /> a - , <br /> � x� R � � , , � .: <br /> 7�" .:, r y ti. s� �e t 1 t �S <br /> � Ericlosed= ,A licable. .:�_4 : ` x �; w - '' �, �_='} �rY <br /> ❑ � Escrow A reement si ned <br /> >, =�F�.�z � «❑ �"f' `:Escrow%�received �/��?-��: �. '' <br /> . ,.. ,:_ . �,�_ . r�, r . . . ._. <br /> C� ❑ F Pre-A lication Form <br /> `.�,::- �V ❑ �` 'A -licafion Fo�m ` ,,; ,.. :�,_�. " f <br /> ❑ Practical Difficulties Documentation <br /> . , „. . . , _ <br /> ,:�.❑, .:� ,_.�."Of '' .� , {.Certified'Pro `ert �Qwners:List„ ea2��.,`F�v�u ,�Pi�/ '� <br /> ,�� <br /> _ a.._,.. _ -. ... . � _ . . <br /> ❑ Surve meetin ALL re uirements shown on a es 5- 6 <br /> r. �« ,Y;- ❑ ':Fro osetl:Plans,..� x � � :ti> z 3 � > �..; <br /> 3 �: ,t a� ,, <br /> . _. ,. � .. w . . .. .. , , .. . .,. . ... . .. . . <br /> ❑ Hardcover Calculation s — q��u.��T �� p�z�u��--�7 <br /> M� ;:� ` �� r�Se fic'S`stem Site„Evaluafion�Re ort , ` ::� <br /> ❑� Wetland Delineation <br /> 0� �;: ; �UVetlarid`"Buffe�E�aluatior�� � ::{ `'r: `; �R - <br /> a, , <br /> �,.. _ _ . . . .. .. , .._. ... .. . _._.,_, ,� . . . <br /> ❑ Buffer Im rovement Plan <br /> .., . -_- _�- �. 4 - <br /> :. �`•�❑ ;,`• . .i�xr�N6:�:P�.''� � .�t-�r�..� °�--�e:., fi� �r; rt: <br /> , <<� . <br /> . <br /> ;: =r; <br /> . .� <•. ; ,� ��., .. . .. <br /> ,�_ <br /> APPLICANT AND/OR OWNER: <br /> • Agree to provide all information required or requested by the Planning Department, <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 denial 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 further 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 and/or Owner acknowledge they must be present at all scheduled review meetings of the <br /> Planning Commission and Council. If 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 applicant/owner and <br /> advise the City Planner assigned fo your project. <br /> • Some or all of the information that you are asked to provide on this application is classlfied 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 informafion is to annually update <br /> our records and records other governmental agencies required by law. If you refuse to supply the <br /> information,the applicaf n may not be issued <br /> Applicant's Signature: % Date: .�,�_,� �� � �� <br /> Applicant's Signature: Date: � <br /> Owner's Signature: . Date: �Ly �_ ��Z, <br /> Owner's Signature: Date: �Ly �,, ��Z � <br /> r <br /> ' - ' ����0��� <br /> - 13- <br /> JUL 19 2011. <br /> CITY OF ORONO <br />