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CITY OF GEM LAKE, MN <br />i 4200 Otter Lake Road <br />i <br />- Gem Lake, MN 55110-3227 <br />Telephone 651-747-2790 <br />Cityna.aemlakeA'IN-o r<a <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) �v �.,.�, PHONE(Home)� t-�>G,3C�3 <br />r . , (BusinessYZ-L—�•L,%yS Y <br />(Cell) <br />ADDRESS 'a • c� <br />PROPERTY <br />OWNER /us?q10�11- <br />ADDRESS OF n(, ZONING <br />SITE �, �Gx ip, 6?4-, <br />EXISTING USE OF SITE 1 <br />DESCRIPTION OF CONDITION( USE BEING REQUESTED <br />V_ 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 />j 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 />