DRAFTED BY:
City of Farmington
430 Third Street
Farmington, MN 55024
Applicant: ______________________________ Telephone: _______________ Fax: ________________
Address: _____________________________________________________________________________
Street City State Zip Code
Owner: ___________________________________ Telephone: ______________ Fax: ______________
Address: _____________________________________________________________________________
Street City State Zip Code
Premises Involved: _____________________________________________________________________
Address/Legal Description (lot, block, plat name, section, township, range)
Current Zoning District ______________________ Current Land Use ______________________________
Specific Nature of Request: ______________________________________________________________
_____________________________________________________________________________________
SUBMITTAL REQUIREMENTS
____ Proof of Ownership ____ 6 Copies of Site Plan
____ Application Fee ____ Abstract/Residential List (required 350’ from subject property)
____ Boundary / Lot Survey ____ Torrens (Owner’s Duplicate Certificate of Title Required)
________________________________________ _________________________________________
Signature of Owner Date Signature of Applicant Date
CONDITIONAL USE PERMIT APPLICATION
Request Submitted to Planning staff on_______________ For office use only
Public Hearing Set for: __________________ Advertised in Local Newspaper: _____________________
Planning Commission Action: ______Approved ______Denied Fee Paid
City Council Action (if necessary): ______Approved ______Denied $250 – City of
Farmington
Comments:
________________________________________________________________________________________
________________________________________________________________________________________
Conditions Set:
________________________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
Planning division: ___________________________________ Date: _____________
9/10/2019
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