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CITY OF GEM LAKE, MN <br />4200 Otter Lake Road <br />Gem Lake, MN 55110-3227 <br />Telephone 651-747-2790 <br />City(&xemlakeMN.org <br />INTERIM USE PERMIT RECEIVED <br />APPLICATION FORM <br />INTRODUCTION TOWN OF WHITE BEAR <br />A Conditional or Interim Use Permit may be granted or denied by the City Council after <br />recommendation by the Planning Commission in accordance with Ordinance No. 43J <br />(Zoning), Section 17.5, Conditional and Interim Use Permits. <br />APPLICANT(S) PHONE (Home) <br />(Business) <br />_ (Cell) lr,S } <br />ADDRESS ��U � �-�ut���� � <br />PROPERTY t <br />OWNER <br />ADDRESS OF ZONING <br />SITE 40�Q rNsn t CA. <br />EXISTING USE OF SITE k Vie_' tI <br />DESCRIPTION OF INTERIM USE BEING REQUESTED <br />l(atl �e CP Cl�r �a) l �!1�Cii i 9tr'e <br />Va"Ace-Pa �tcmm I .. C' (K7 Z P'(1te <br />�� , arc Pis \ es <br />Fee: Conditional or Interim Use Permit (Other than a PUD) <br />$600 + $1000 escrow for review <br />CHECKLIST: <br />Site Plan <br />Building locations (dwelling, garage, accessory building). <br />Site improvements (parking areas, drives, sidewalks, <br />fences, decks, lighting, etc.). <br />Yard (front, side, rear setbacks). <br />Wetlands (delineation of streams, water bodies, wetlands & <br />100 year storm elevation). <br />Existing trees (6 inch in diameter or more), large shrubs & <br />proposed landscaping. <br />Location of site, with adjacent land use. <br />Topography, grading. <br />