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Laga\ Description of Property L£±�� B/ �_-_ / - � a`'k-
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Owner: Name M in ow t s4 5�nV- _ _~ ,
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Address: ___���_���
City: R,Jp/m __ State: /�!V Zip: 512213 __-
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Telephone: (Hnme)________-_ (Bu�neao) �7�7^��_�_ - _
(Fax) 607` b:37^ 430 7 (Other)_
Lorene FClark ~ __�
/\puUoaut: Neme __-__ _. �____________--__''-__--___�
City: Stillwater TA
State: ZiT 55082
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Telephone: (Home)_____.6 ,oh|b���
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Type of Request(s)--� Zoning OiotrictAmendment _--_--'�' '~^ -Occup '
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Variance: ~' Ar Amendment
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yu ,unceOderReo`doutioNCm*ru�Nn�u _ pUD: Cmnoop Plan 8ubdWision Plan - -
Subdivision: 'Street Vacation `
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Comprehensive Plan Amendment ___ City Financial Assistance
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Description of RequaStkS) ' r0 lL6(~
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|fa request for p\mnn|0Q/zoM}uQandmnon the subject site orany pa rtthernufhaubaon
prIOU$l approVed please describe It below:
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Uri:vele-xi-lent Application, Page 2
General Conditions
Application Review
ie undersigned acknowledges that before this request can be considered and/or approved, all
nouited information and fees, including,any deposits, must be paid to the City. An incomplete
cpolioation will be returned to the applicant The app ication approval process commences and
an applicat on is considered complete when all required information and fees are submitted
:7probriately to the City.
Professional Fee Responsibility
It is the understanding of the undersigned that all City incurred professional fees and expenses
associated with the processing of this request(s)will be promptly paid upon receipt, If payment
,s not received from the applicant, 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.
Applicants will be billed on a monthly basis for Planning, Engineering, Legal and Community
Development fees as they are acci ued. It is understood that interest will be charged on the
acccunt at the maximum rate allowed by the Fair Credit Act If It becomes thirty (30) days past
L. FE:lure to pay administrative and processing fees In a timely manner may result in denial
ci !ne appiication. All foes must be paid at the time of application and shall be paid prior to the
;ssnanco ol a hull:ling permit,
The undersigned applicant further acknowledges and consents that all unpaid fees owing the
City of Oak Park Heights shall be treated as unpaid utility fees and may be certified for
collection as with delinquent utility billings and may be assessed against the subject real
property If unpaid by October 318 of each year
PI operty Address )1■)()(- )C Memorial AVG N
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4,4.`4 t ii4. c.c....Le I: 741 Pt.k •
41-e.,-- Date: 7/7/t-5---- 400 0 6/4.10115
Owner ,:g ature \4,1441: \I.t?
A .-4111:(0,40/011111IIPP-7,— 441/1/,../e, —1,0 —/5— I
Date:
Ap• cant Sig,attire