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City of Gem Lake <br />Heritage [fall <br />4200 Otter Lake. Road j Gem Lake, MTV 55110 <br />6..51-747-2790t92 1651 -747-2795 (fax) <br />E-mail Cil.}'�ii11!Cn7l1l t tnn.t]rt? <br />Conditional Use Permit <br />Cmi dilioifal Lve Permit may be gramed or (lemiod by Ihe. City+ by the Ptaniti► g <br />►r►ui.tsio►r trr uct•urdance with Ordinance :Ya,..131 (za►rirrg), Section 17.5. Com itirmal andlnieri►►+ Use Peruriis: <br />LICENSE APPLICATION CHECKLIST. <br />To prevent delay, plc:)sc ensure the follMVltiF fuformatimi is suhmitted where n 11100 151c. <br />0 Permit Fee (if payingw.ith cash Nve.can d.nly.acccpt cNact change) <br />0 0775.00 (payable to the -City of Cetii Lake) <br />0 Site Plan <br />0 Btdlding Locations (dwellin-gs, gavagr, accessory buildings) <br />0 Site Improvoincrits (parkifig.arcas, drives; sidewalks, fences; becks, lighting, etc..) <br />0 Yard (front, side. rear Setbacks) <br />0 Wetlands (dcIinctit ion of streams,. %valer h0dics, wctk'nds :& 10.0. year.sl0rrn elevaIi.n.n) <br />0. l~xisting 'Trees (6 incli in. diameter. or mot 0, large slirubs & proiiosed Iiiirlscap 1ng <br />0. 1.0cation of•sim, with adj4cciA land usu <br />0 Topography, Grading;. <br />0 Schedule (when applicant intends to corimuct) <br />0 Adtdrionai inf6miation, ifrequired <br />0. Permits or written comments from other agencies; <br />(DNR, RCWD, VLAWN4.0, Ramscy County, MnDQT, US Ariny'CmTs of Enginccrs) <br />0 Certificate of S;.irvcy cir full legal desvripiiaii <br />0 Building plan: (sine, intended use of stnictures, exterior tinlsllcs, floor plaits and elevations) <br />nfor[i�atinri <br />TOle; <br />F ub5 - "*6 <br />j Iiollit; F'IiUl1C- .' Cclh jpyOI - ? 7{.7 4�p!$ 1"1' % I3LSS1tiCs5; <br />I <br />iZAM�p_yTom!At4[14Fj e <br />f <br />€ I'r�pei't}• [3�tzirr: ��"F'F I�t�.�_._....��'1M�3 ._.._ _...�..._._._ <br />f <br />f <br />Site Addvcss.: 3 <br />Clb; � Up�4 Smte: f' L _ "lip: 55])D <br />i F <br />I Pr6pert} is. zoned as: a1 tD>rM"ttF► t. Existirig use of the site: <br />E <br />i)�scriplion of Conditional Use being requested: Ci.T:n-.!54-X>Q�.1�-6d-ea(*A V <br />3 <br />1[ H.lC�1 _ _PrL�Y2 LAVI�1 Eau►Pr+1- t>a� R►-Oo_ A 0 DNu5 MP-aDM <br />Afplictirit Signature: <br />.._,.___..._...__.- W... Cisy:nf 6iii Lukc Cwiditiciii)I Llst Nrjna - •s'4sev l 0f:i <br />