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i <br />City of Gem Lake.. F <br />heritage trail i <br />er Lake Road j *Qeni Lake,* MN 55I 10 <br />147=279ON2 ! 651-747-2795 (fax.) <br />F-1naiI city [a icnil:>kci7in:nrsr <br />. i. <br />Conditional Use. Permit <br />Conditional Use Permit may begriinted-or denied by the OorCounOl-after recommendation by the Plannln'g <br />inns rsion in accordance a=ilh. Ordinance Xo. 131(zotting), Seerrart -17..5 Conditiortat u1jr Interim Use Permits. <br />LICENSE APPLICATION •CHECKLI-8T: <br />To prevent delay, plense ensure the foltow€ng infor»natiou Is sitbrultted wherc applicable <br />0 Permit Pee (if paying with cash we can only accept exact chxttgc) <br />J. .3375.00 (payable to the City of Gein Lakel <br />C Site flan <br />G Building Locations (dwellings, garage, acceswry Buildings) <br />O Site Improvowenl.s.(parkirig areas, drives, sidewalks, fences, deckj, lighting, ctc.) <br />O Yard (front, side, rear sctbacksj <br />❑ Wetlands (delineation of st1•eams, water borlies,.wetfatnds & 100 year stoan elevation) <br />a Existing Trees.(6 inch in diameter or rnore), large shrubs.& proposed landscaping <br />O L.ocatign of site, with adjacent land use <br />© T6pograiphy, Grading <br />O Schedule (when applicant intends to consmici) <br />* Additional infortnntitm,.if required <br />O Pennits. or wrim n epnnrrients from. pther agencies: <br />(r)Nip, RCWD, VLANVM0, Ramscy County, MOOT, US Army Corps of Ehkiucct ) <br />I?. Certificate of Survey or.full legal duscripliwt <br />* Building plans (si e, intended use of structures, exterior finishes, floor plans and elevatipris) <br />F�M7LC-S <br />Cost- a"35- 89A <br />Call: tp l • 7 75 - 4647 gusineic: _ N r4 <br />Email: e8 1 PS f'+1 A Np�l A 6 CyMA 1 L 1v1 <br />S 4 A(ldress: 35�5 5tri�t�N�M�tN for o _ _ <br />I.ALC� State: _ Zip: 55 A (D --- <br />is zoned as:. e;y^V\ v5r-miff . Existing use of tilt site: exzl Ma:!LC <br />of Conditional' Use beingrequcstcd: {�6jL-5-or-sat_. <br />Sifnaturc:44& <br />Date: tiC;� I --- -- <br />City or Orin Lnke CUM1111031.11 USe Pcroiit - Page I of 3 <br />