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<br /> REQUlRED SUBMITTALS:
<br /> A(1 of the following information must be submitted by the application deadline date in order for your application to
<br /> be processed.
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<br /> ❑ ❑ Escrow A reement si ned
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<br /> ❑ Pre-A lication Form
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<br /> ❑ Certifietl Pro ert Owners List
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<br /> ❑ Pro osed Plans
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<br /> ❑ Se tic S stem Site Evaluation Re ort
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<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 /> • Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the
<br /> Planning Commission and Councit. 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 assi ned to your project.
<br /> �. Owner's Signature: Date: �t��/(Z
<br /> � Owner's Signature: Date:
<br /> Applicant's SignatUre:�� �� Date: '�/'G�Z
<br /> Applicant's Signature: Date:
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<br /> Np� � 6 201Z
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<br /> Ci�O� ORf}N�
<br /> CUP 8 Other Land Use Applications
<br /> Updated: January 31.2012
<br /> - 14-
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