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Case Number: <br /> El 2015 Land Use Application Form <br /> RVVe (An individual application for each application is also required) <br /> Application Type Fee Escrow I *Additional App.Req'd <br /> Administrative Subdivision(Simple Plat or Lot $300.00 Yes <br /> split) <br /> $1,000.00 <br /> Concept Review $100.00 $1,000.00 Yes <br /> Conditional or Interim Use Permit $275.00 $1,000.00 Yes <br /> Easement Vacation Street,Drainage/Utili $275.00 $1,000.00 Yes <br /> Fireworks(Temporary sales and storage oo $100.00+Licensing Fce No Recording Re 'd Yes <br /> General Planning Permit $100.00 $1,000.00 Yes <br /> Land Use Amendment $275.00 $1,000.00 Yes <br /> Ordinance Amendment $275.00 $1,000.00 Yes <br /> Plat <br /> Preliminary $275.00 $1,500.00 Yes <br /> Final $275.00 $1,000.00 Yes <br /> Site Plan Review $100.00 $1,000.00 Yes <br /> Subdivision Exemption $100.00 $1,000.00 Yes <br /> Variance or Appeal of Zoning Decision $275.00 $1,000.00 Yes <br /> Zone Chane $275.00 $1,000.00 Yes <br /> RECORDING FEE(Apps w/No Escrow $46.00 Yes <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 Parcel Number: 75 - (Please attach complete legal <br /> description) <br /> Applicant Information (please print) <br /> Name: Elk River Landfill, Inc. E-mailaddress: ihamann@wm.com <br /> Address: 22460 HWy 169 NW Elk River _ N 5533() <br /> Street City State Zip Code <br /> Phone(w): 952-656-7283 Fax: 763-441-2025 Phone(h): <br /> Signature: 24J <br /> "_ — Date: <br /> Thomas Areaulleu IV <br /> Property Owner Information (please print) Same as Applicant ❑ Different,as below ❑ (Check one) <br /> Name: Waste Management of MinneE-mailadd ess' jhamann@wm.com <br /> Address: 20520 Keokuk Avenue Lakeville MN 55044 <br /> Street City State Zip Code <br /> Phone(w): 952-656-7283 Fax: 763-441-2025 Phone(h): q <br /> Signature: . Date: <br /> Thomas Beaulieu 01 <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 /> M\DepartmentACommunity Development\Planning\Adrrnn''•,Apphcation Forms\Land Use Application Form.docx 1/26/2015 last Modified <br />