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CITY OF GEM LAKE, MN <br />%j 4200 Otter Lake Road �( Gem Lake, MN 55110-3227 — <br />Telephone 651-747-2790 <br />City(ai.gemlakeMN.org <br />CONDITIONAL USE PERMIT <br />APPLICATION FORM <br />INTRODUCTION <br />A Conditional 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) A(- t i(t _De l QC' C 0 <br />G11cc,.e? <br />ADDRESS Gif11 7/lu C AV <br />Alf4 e LIJ o d /4V S Q0-1( <br />PROPERTY l / <br />OWNER )CcC �� n <br />PHONE (Home) <br />(Business) <br />(Cell) �C�3 -Y5 <br />ADDRESS OF / ZONING C2C&.2�. <br />SITE .35 �T/0 ��,1 C( r! <br />EXISTING USE OF SITE �f {��• � �i7� �� �U D C�'cr � " <br />DESCRIPTION OF <br />.11')o <� PI v I -C f =Gc <br />CONDITIONAL/ USE <br />�/� <br />BEING REQUESTED <br />r <br />/ Fee: Conditional or Interim Use Permit (Other than a PUD) <br />$250 + $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 />