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Case Number: dzL/3-/l <br /> E11 _ _ 20 15 Land Use Application Form <br /> River (An individual application for each application is also required) <br /> Application Type Fee Escrow I *Additional App. Req'd <br /> Administrative Subdivision(.Wimple Nit orLot $300.00 $1,000.00 Yes <br /> ,f` lit <br /> Concept Review---,-_ $100.0{7 1,0i)C7.00 Yes <br /> Conditional Interi se Permit 275.00 _ 1,0 Yes <br /> Easement Vacation Street,Drainnge/Utility) $275.00 51,000.00 Yes <br /> fireworks(Temporary sales and storage of) $100:00+Licensing Fee No Recording Re 'd Yes <br /> General Planning Permit $100.00 $1,000.00 Yes <br /> Land Use Amendment $275.00 51,000.00 Yes <br /> Ordinance Amendment 5275.00 $1,000.00 Yes <br /> Plat <br /> Preliminan, $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 51,000.00 Yes <br /> Variance or Appeal of Zoning Decision $275.00 $1,000.00 Yes <br /> Zone Chane 8275.00 51,000.w 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 (pleasep/rint) -]/�/� n /'�, <br /> Address: M < T• � Parcel Number. 75- rt/7 - "��-+(Please attach complete legal <br /> description) <br /> Applicant Information (bleaseprint) <br /> Name..'&v) gav- �s i4IL E-mail address: C1 @ e bri a 9S Cdrn �tl CcJv►1. <br /> Address: l i oL l r QEE Pa RT S-r, SmseteE 1 k- A l'pl M. &o <br /> Street City State Zip Code <br /> Phone(w): 1103- 1)aS-1690 Fax:,b3-(o 33-1�3L3 Phone(h) <br /> Signatu: . ���� hate: al5 <br /> Property Owner Information (pleaseprint) Same as Applicant M Different,as below � (Check otre) <br /> Name: E-mail address: <br /> Address: <br /> Street City State `Lip Code <br /> Phone(w): lax: Phone(h) <br /> Signature: bate: <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 Forms\Land Use Application Form.docx 7/23/2015 Last Modified <br />