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Page 2 of 2 <br /> IV. Property & Contractor Information: <br /> Street Location/Address of Property: 761 1st St SW New Brighton, MN 55112 <br /> Property Identification Number (PID): 323023120020 Zoning District: 12 <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 /> Architect (if applicable): Houwman Architects Phone: 651-631-0200 <br /> Surveyor/Engineer (if applicable): Phone: <br /> Builder (if applicable): Phone: <br /> V. Main Contact Person <br /> ❑ Property Owners <br /> Other (if other, please fill out the information below) <br /> Title (Position or relation to property owners). A Tree Service currently leases property <br /> Denise Volk (owner) 761 1st St SW <br /> (name) (address) (st) (zip) <br /> 612-633-6835 dvolk.atreeservice@gmail.com <br /> (phone ff) (fax #) (email) <br /> VI. Notice of Fees <br /> As set forth in the City Fee Scnedule 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 Iimrted to, direct city payroll and overhead costs. fees paid to consultants and other <br /> professionals, and the cost of pnnting. 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 poor action until all miscellaneous fees are paid. The Crty may require additional deposits, if deemed necessary. The property owner <br /> agrees to allow city statf and commission members to access the property per this application for inspection. <br /> I acknowledge that I have read the above statement and fully 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: mot Date: %A.:3((-Qin <br /> ADMINISTRATIVE USE ONL Y: <br /> Date Application Received. PC Date: <br /> Fee Paid: CC Date: <br /> Escrow Paid: <br /> Receipt Number: Form Last Updated 10. 18. 18 <br />