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REt�U1RED StIBMI'1`fAI,S: <br /> AiI of tho followirtg irrformation must be submitted by t#�e application deadline �ate in order far your <br /> appiication to be prooessed. � � <br /> � n Escrow reement si ned <br /> ❑ D P i�ation Form <br /> CJ L] PcacticaE Difficu�iee Dowrnentation <br /> ❑ Q Surv meetl ALL uirements <br /> ❑ 13 Har�dcover Calculs�on s <br /> ❑ D Wetland DellneaHon <br /> ❑ ❑ Buf#er irn rovement Plan <br /> <t� <br /> APPI.ICANT AND10R O�WNER: � . �. .. <br /> • Agrise ta provide efl ininm�at+on requfired or requested by the Piannl��g Departrnent, <br /> • Agr�ee to pny additiona!fees{staff fiime nat cavered 'm the eriginal f�ee psymeM) end/or cansutfsant expenses <br /> incurned in revtew o#this spplice�on,and <br /> • Cerdfy that the information supplied is ttue and cotrect to the best o#hisJher fmowle�ge. The appiicer�t and <br /> owr�sr�co�nise t6�t they ars solely re�pon�tbl�for subntl�q �camp�te#pp�iestion befng awero <br /> th�t upon faliu� to do so1 the statf ftas �o �It�m�tive but t� njscE ft unEll it Is compls� o�r !o <br /> . racanmend ths roqu�st for dertial 01 the roque►st repardless of it�potatrtli�l rrnEit. <br /> • Aakc�avsriedge the Escrow Agreemerrt is comptemd and eigned. � �" . <br /> • The O�wner hereby admo�wiedges and agrees to thl&application and further aathori¢es�sanable er�ry an6�� <br /> the property by City StaTf, vonsuttants, agents, Commiasipn and Coancit Members for purpoaea of • <br /> investigafrori and ve�ification of thts re�ueat. <br /> • Appifcarrt anii/or Owr�er acla�owi�dga they m�st be present at all echaduied rovlsv+r meetin8� of the <br /> �lannin�ComrMsslon and Cauncfl. ff an applicant andlor owner is unab�e ta atbend a scheduled meeti�tg, <br /> piease fnake arr�ngements to have en authorized rep�+esentative.�ttend in plax of�te applicantlowrtec and <br /> advise the CfEy Planner assigs�sd ta Yc�ur ti+'a1� • <br /> < <br /> ApPiicant's Signature: � Date: -s I 9 / � <br /> ApplicanYs Signature: Date: <br /> Owner's Signature: Date: <br /> O�wne�'s Signatune: D�te: <br /> . RECE�VE�} <br /> . . . � � aPR 2 6 201� <br /> Verianoe ApA!'��UPd�: J�nuary 31,20t2 <br /> � '� � � oNo <br /> � . .,. • -��- �F� <br />