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(attach additional sheets if necessary) � REQIIIRED SIIBMITTALS _ AlI of the followinq information must be submitted by the ap lication deadline date in order for your application to be considered com lete: - 1. Completed Application Form • 2. Certified Property Owners List of owners within 150' (you must obtain this list from Hennepin County Department of Finance A-603 Govt Center 348-3271) . • 3. Plat Map (obtained with property owners list). • 4. Certificate of survey (signed by a licensed surveyor) to include hardcover calculations as required (provide one (1) copy 8�"xll" f or reproduction) . � 5. Topographic survey (existing and proposed elevations) if any changes in existing grade are proposed (provide one copy 8�"xll"). • 6. Sketches or plans of floor & elevation views (provide 1 copy 8�"xll"). 7. As an addendum to this application, please attach a separate list of any other persons you wish notified of this application. 8. Additional items as may be requested by City staff. The Applicant and Property Owner must sign this application. Please remember that your variance application is not complete if the above information has not been included. --------------------------------------------------------------------------- APPLICANT'S SIGNATOR$ The applicant hereby agrees to provide all information required or requested by the Zoning Administrator, agrees to pay additional fees (staff time not covered by original fee payment) and/or consultant expenses incurred in review of this application, and certifies that the inf ormation supplied is true and correct to the best of his/her knowledge. Applicant' s Signature Date �� OWNERS SIGNATIIRE The owner hereby ackowledges and agrees to this application and further authorizes reasonable entry onto the property by City staff, consultants, agents, Commission members, and Council members for purposes of investiga- tion and verification of this request. owner' s Signature 4'�---- �`=��` Date %u/2 a�`13 ------------------------------------------- ------------------------------- Applicant must have all submittals into t City offices 25 days before the Planning Commission Meeting. Planning Co ission Meetings are held on the third Monday of each month. Applicants must be present at all scheduled review meetings of the Planning Co�nission and Council. If an app licant is unable to attend a scheduled meeting, please make arrangements to have an authorized agent attend in your place and to advise the Building & Zoning Office of this change prior to the meeting.