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Page 2ot2 <br /> IV. Prop,oi Ctor hiikailitLanNtn;i: <br /> Street Location/Address of Property: 1900 Rush Lake Trail <br /> { Property Identification Number(PID): -- Zoning District MX <br /> Legal Description(From Deed or Certificate of Title): ❑ Please see attached <br /> Lot: 1 Block: 1 Addition: Applewood Point of New Brighton, <br /> Ramsey County, Minnesota <br /> Property described is by: El Abstract ❑ Torrens—Certificate#: <br /> Location of Certificate: <br /> Architect(if applicable): James W. O'Brien, FAIA Phone: 651-341-4978 <br /> Surveyor/Engineer(if applicable): NA Phone: <br /> Builder(if applicable): _ NA Phone: <br /> V. Main Contact Person <br /> ❑ Property Owners ! • <br /> Other(if other, please fill out the information below) Member of Cooperative <br /> Title(Position or relation to property owners): <br /> James O'Brien 1900 Rush Lake Trail 55112 <br /> (name) (address) (st) (zip) <br /> 651-341-4978 jameswobrien35@amail.com <br /> (phone#) (fax it) (email) <br /> VL 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 consonants 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 at 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 d fully understand that lam responsible for all costs incurred by the City in the processing and <br /> reviewing of this application. <br /> Property Owners Signature: A- �- _ Date: l i L' <br /> ADMINISTRATIVE 114E ONLY: <br /> Date Application Received: PC Date: <br /> Fee Paid: CC Date: i <br /> Escrow Paid: ._ <br /> Receipt Number: Form Last Updated 10.18.18 <br />