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1 . COMPLETED LAND USE APPLICATION <br /> Page 2 of 2 <br /> IV. Property&Contractor Information: <br /> Street Location/Address of Property: 1101 Black Oak Drive, New Brighton, MN 55112 <br /> Property Identification Number(PID): 193023340051 Zoning District: R 3B, B 1 <br /> Legal Description(From Deed or Certificate of Title): ❑Please see attached <br /> Lot: Block: Addition: <br /> Property described is by: ❑Abstract ❑ Torrens—Certificate#: <br /> Location of Certificate: <br /> Pope Architects 651-642-9200 <br /> Architect(if applicable): Phone: <br /> Sunde Engineering 952-881-3344 <br /> Surveyor/Engineer(if applicable): Phone: <br /> Builder(if applicable): Yanik Companies(Developer&Design/Builder) ?hone: 952-471-9199 <br /> V. Main Contact Person <br /> ❑ Property Owners <br /> x Other(if other,please fill out the information below) <br /> Title(Position or relation to properly owners): <br /> David R.Yanik 4400 Shoreline Drive, Spring Park, MN 55384 <br /> (name) faddressl (nil (lint <br /> 952-471-9199 952-471-9196 davidyanik@yanikcompanies.com <br /> (phone#) (fax#) (email) <br /> VI. Notice of Fees <br /> As set forth in the City Fee Schedule and pursuant to applicable law,the property owner shall be responsible to reimburse the city for all related <br /> miscellaneous costs incurred pursuant to the processing of this application. Note that these reimbursements may exceed the amount of the original land <br /> use application fee. Such expenses may include,but are not limited to,direct city payroll and overhead costs,fees paid to consultants and other <br /> professionals,and the cost of printing,mailing,and supplies. These miscellaneous fees are due immediately upon notification by the City. The City shall <br /> provide,upon request,an itemized statement of the various expenses incurred by the City. The City may withhold final action on a land use application <br /> and/or rescind prior action until all miscellaneous fees are paid. The City may require additional deposits,if deemed necessary. The property owner <br /> agrees to allow city staff and commission members to access the property per this application for inspection. <br /> I acknowledge that I have read the above statement an y understand that I am responsible for all costs incurred by the City in the processing and <br /> reviewing of this application. <br /> Property Owners Signature: Date: Z <br /> ADMINISTRATIVE USE ONLY: <br /> Date Application Received: PC Date: <br /> Fee Paid: CC Date: <br /> Escrow Paid: <br /> Receipt Number Form Last Updated 10.18.18 <br /> 2 LAND USE APPLICATION: 1101 BLACK OAK DRIVE, NEW BRIGHTON, MN 55112 FEBRUARY 14,2020 <br />