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Case Number: -01 <br /> City or <br /> Elk. 2013 Land Use Application Form <br /> R1Ver (An individual application for each application is also required) <br /> Application Type Fee Escrow I *Additional App. Req'd <br /> dmi st-rative ubdivision'(Sir#kPlat,r.it Ye <br /> .f art �t10 00 $1{100m00 <br /> Concept Review S100.00 51,000.00 Yes <br /> Conditional or Interim Use Permit 5275.00 51,000.00 Yes <br /> Easement Vacation Street,Drainage/Utility) $275.00 S1,000.00 Yes <br /> Fireworks!(f o �sales and.star of) $100.00+licensing Fee No Recording Re 'd Yes <br /> General Planning Permit $100.00 $1,000.00 Yes <br /> band Use Amendment $275.00 $1,000.00 Yes <br /> Ordinance Amendment $275.00 $1,900.00 Yes" <br /> Plat <br /> Preliminary $275.00 $1,500.00 Yes <br /> Final $275.00 51,000.00 Yes <br /> Site Plan Review $100.00 $11000,00 Yes <br /> Subdivision Exem t'on 5100.00 $1,000.00 Yes <br /> Variance or A eal of Zonin Decision $275.00 $1,000.00 Yes <br /> Zone Chan e $275.00 $1,000.00 Yes <br /> RECORDING PEE LAMs wNm Escmw $46.00 `e <br /> Professional Staff Services $50.00 per hour <br /> 1. Escrow deposit applied to consulting,legal,engineering,and professional staff services. Costs incurred above the <br /> escrow amount will be billed monthly. Remaining balances will be refunded to the party that posted the escrow. <br /> Information will be sent via email unless otherwise requested. <br /> Property Information (please print) <br /> Address: 22460 Hwy 169 NW, Elk River Parcel Number: 75- - (Please attach complete legal <br /> description) Multiple Parcels,see attached <br /> Applicant Information (pleaseprint) <br /> Name: Elk River Landfill, Inc. Email address: lhamann @wm.com and sstolz @wm.com <br /> Address: 22460 Hwy 369 NW Elk River MN 55330 <br /> Street City State Zip Code <br /> Phone(w): 952-656-7283 Fax: 763-441-2025 Phone(h) : 612-239-7779 <br /> 0 <br /> Signature: r t vim. Date: <br /> Property Owner Information (please print) Same as Applicant ® Different,as below ❑ (Check ore) <br /> Name: E-mail address: <br /> Address: <br /> Street City State Zip Code <br /> Phone(w): Fax: Phone(h) <br /> Signature: a`z °° Date: I V I <br /> Purpose of Fees and Escrow <br /> Fees <br /> The application fees are used for staff time for the assembly and distribution of the application materials, <br /> administration of internal and public meetings,publication of the public hearing notice in the Elk River Star <br /> News,and for postage to mail the required notices to adjacent properties. These fees do not include <br /> professional staff review time,recording fees or additional publication fees. <br /> N:\Departments\Community Development\Planning\Admin\Application Foams\Land Use Application Form.doc <br /> 8/14/2013 Last Modified <br />