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2004-08-14 Zoning Requestr CITY OF ALBERTVILLE ^ 70NING REQUEST APPLICATION 5975 Main Avenue NE P.O: Box 9 Albertville, MN 55301-0009 (612) 497-3384 fax(ti12) 497-3210 Please read carefully and answer all questions thoroughly. Only complete applications will be accepted after validation by the City Clerk and prior to acceptance of required processing fees/deposits. Street Location of Property: ~ r 7o r 7~+~ ~ ,~~ Legal Description of Property (Attach additional sheet if necessary): ~~ C~ ~~ Owner: Name: ~~~; Case No:_ ~'~+~. ' ' ~ ~ ~ Base Fee ~ ~ ~;-; .. ~ ~ . t _~. Escrow Amt: ~ Pd ~ ~ ~ . ,z~;, ... Date Filed: ~ ~ a ` ~- ~._~~;>~._~, /' Address: ~ 4'S (O `T~~ 5-~- City: ~-i m~'c.~ ,„ ~ State: mlU Telephone (Home): Applicant (If other than owner): Owner: Nasrse: Addres City:. C~ ~'~ L..r~,jl.~ State: /Y11~ Zip: ~3(r~o`~ Telephone(Home)7(A3-a~c~Si~-Ot~~O(Business)7~3~~~-41,4-(v (Fax):71.3-c~r S~~178 Type ~f Request(s): Site and Building Plan Review Rezoning Minor Subdivision/Consolidation Variance Preliminary Flat --~-~ Conditional Use Permit Final Plat Interim Use Permit Comprehensive Plan or ~~--- Planned Unit Development Ordinance Amendment Other Description of Request{s): ,{ ~ Zip: ~5V37tc? (Business):7L.3 -~ 7 - ~4(~ (Fax): r .M / t~2. Page Two, City of Albem~ille PlaiiningiZoning Application Reason Why Request Should Be Granted: ~,,.~, [ f fir, IJaisting DTs of the Property /Nature of Facility or Business: If a request for aplanning/zoning action on the subject site or any part thereof has been previously sought, please describe it below: What? _~j(\ ,Q ~(t?VG ~ _ When? ~CJ ~; Praject Name, if applicable: ~11.t/7~ ~ ~ (~..- 1 hereby apply for the above consideration and declare that the information and materials submitted with this application are in compliance with City Ordinance and Policy Requirements and are complete and accurate to the best of my knowledge. I understand that the application will be processed fc; the next available meeting agenda after review of the information submitted to determine if any other data is needed and after completion of a stafjreport. I understand that all City incurred professional fees and expenses associated with the processing of this request are the rYspcsnsibitity of the property owner andior applicant and should be promptly paid. If payment is not received from the appllcrxnt, the property owner acknowledges and agrees to be responsible for the unpaid fee balance either by direct payment or a special assessment against the property. (If the property fee owner is not the applicant, the applicant must provide written authorization by the owner to make application.) Sixty (60) Day Waiver: The City hereby notifies the applicant that development review may not be completed within the required 60 days due to public hearing requirements and agency review; therefore, the City is taking an automatic 60-day extension for development review. Develapment review will be completed within I20 days unless the applicant approves additional review extensions. °^,,,~ < ~ <_ ~ a ~. Signature(s) of Qwner(s): \ 1 ~`~•~-j~~ ~ ~ Date: ~ ~ d~ ~ `" ~` p ~ _ : ~ ~, ~: Date: Signature(s) of Applicant(s): ~___(..-,.,.~._ Date: 8 ~.~ Date: Approved Denied by the Planning Commission on: (Date) Approved _ Denied by the City Council on: (Date)