CUP 92-02 + � V�,'-�� �l.-{ C.
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� ^ 'l�V U�'� ZONING APPLICATION
SUMMARY FORM ~ �"
Application Number��, �{2 - �
P .I .D.�:
Applicant ' s Name ( Last , First) Owner (if other than applicant)
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Mailing Address (Street , City , State , Zip Code)
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Phone Number: (Day) � �l �"'' l�� �� (Evening)
Property Address �a7 �Q V �j-•'�
APPLICABLE CURRENT ZONING DISTRICT(S) TYPE OF ZONING REQUEST
[ ] R-1-A �] R-2 [ ] B-1 [ ] Concept Review
[ ] R-1-B [ ] R-3 � � B-2 [�C] Conditional Use Permit
( ] �1 -C C l R-� [ ] B-3 [ ] Variance
[ 1 -D [ ] R-5 [ ] I-1 [ ] Zoning District Change
[ � 1-E [ ] R-6 [ ] I-2 [ ] Subdivision Approval
[ ] Ordinance Amendment
[ ] Other
� hereby certify with my signature that all data
�ontained herein as Kell as all supporting data
are true and correct to the best of my knoKledge:
Applicants Signature Date
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OW ers Signature Date
ADMINISTRATIVE DATA SUMMARY
_ ] Proper addendum to application Application received: i�IQr� �� �C.�C'� �
. ] Detailed plans submitted
_ ] Written pro�ect description submitted Fee Paid: � (���"; (,.- ��
Referred to City
PLANNING "COMMISSION ACTION Engineer:
tpproved: without modifications Referred to City
[ ] with modifications Attorney
�enied [ ] Referred to Watershed
District
�ate : Date of Publie
� Hearing Notice
JUNCIL ACTION Date of Public
,pproved: Z without modifications Hearing
[ ] with modifications
�enied : [ ]
ate: RESOLUTION N0:
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� CITY OF HOPKINS
SUPPLEMENTAL DATA
FOR CONDITIONAL USE PERMIT
Application No .
P . I .D. No .
A. GENERAL DATA
NAME OF APPLICANT: �('/�-�/ � ���bt,�rt�
The above named individual , firm or corporation hereby respectfully submits the
following data in support of the preliminary information provided on the
accompanying Zoning Application Summary Form dated _ ' .�" � for the purpose of
securi a Co diti 1 se Permit . � �S
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Contact Person L st Name , First Day Phone No. Evening Phone No .
B. PROJECT INFORMATION
1 . Specify the section of the ordinanee whieh applied to this pro3ect: ' -
2 . Brief narrative description of this request:
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3 . Written 3ustification for request ineluding discussion of how any potential
conflicts with existing nearby land1 use /.will be minimized:
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� . Check all additional supporting documents and data which are being submitted
to help explain this pro�ect proposal: �] sketch plan , [ ] topographic map ,
[ ] detailed narrative , [ ] operation p ans , [�] engineering plans , [ ] flood
plain hydraulie analysi � �] f1Qod �roofi g pl ns and specifications , [ ]
o t h e r (s p e c i f y) }�; 'L�j' ��.,�� ��,..-�- �;�,�. ��a�c�
I hereby certify with my signature that all data �
on my application forms , plans and specifications i 7 _.�� �
are true and correet to the best of my knowledge: �% ) �
Sig at re of Applicant Date
CONDITIONAL USE PERMIT
In accordance with of , the
(Seetion of Ordinance) (Ordinance No . )
City of Hopkins hereby [ ] approves , [ ] denies the foregoing Application for
Conditional Use Permit . If approved , said approval is sub3ect to the following
General and Special Provisions :
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By
(Authorized Signature) (Title) (Date)
SEE REVERSE FOR GENERAL AND SPECIAL PROVISIONS
PAGE 2
CONDITIONAL USE PERMIT
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GENERAL PROVISIONS
1 . This permit is not valid until it has been recorded at the Office of the
County Recorder . A true and correet copy of the full legal deseription of
the affected property must be attached to this document .
2 . This permit does not constitute a building permit , sewage system permit ,
grading permit , land alteration permit , well permit or the like . Separate
permits may have to be applied for and obtained in order to accomplish all
the goals of the projeet authorized herein .
3 • The issuance of this permit does not negate the need to secure other permits
from other local units of government , state ageneies or federal agencies who
may also have jurisdiction over portions of your projeet .
SPECIAL PROVISIONS
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E%PIRATION.
A Conditional Use Permit expires one year after it has been issued unless the
use for whieh the permit has been granted is in effect . Extensions may be
granted provided the applicant submits a letter to the Zoning Administrator
requesting an extension 30 days before the expiration of said approval . The
letter shall state the faets of the request , showing a good-faith attempt to
utilize the Permit , and it shall also state the additional time being requested
to begin the proposed construction . The City Couneil may grant extensions not
to exceed one year .
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