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<br /> REQUIRED SUBMITTALS: �
<br /> _ Ail of the following information must be submitted by the appiication deadfine date in order for your appfication to
<br /> be processed.
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<br /> � ❑ Escrow A reement si ned
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<br /> ❑ ❑ Pre-A plication Form
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<br /> ❑ ❑ Certified Pro e Owners List
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<br /> � ❑ Se tic 6 stem Site Evaluation Re ort
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<br /> ❑ ❑ Wetland Buffer Evaluation .
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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 appfication, 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 regardiess of its potential merrt.
<br /> • Acknowledge the EscrowAgreement is completed and signed.
<br /> • The Owner hereby acknowledges and agrees to this applic2tion 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 App(icant acknowledge they must be present at all scheduled review meetings of the
<br /> Planning Commission and Council. If an appficant and/or owner is unable to attend a scheduled meeting,
<br /> please make arrangements to have a thorized representative attend in place of the applicant/owner and
<br /> advise the City Planner assigned to o project.
<br /> Owner's Signature: Date: �� 'Z���/ ?�
<br /> Owner's Signature: Date:
<br /> AppficanYs Signature: Date: / 0 �� zs - ��� 2—`'
<br /> Applicant's Signature: / Date:
<br /> � RECEIVlED
<br /> CUP&Other Land Use Applications o� �� �O��
<br /> Updated: January 31,2012
<br /> - 14 C:���F�����
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