CITY OF ROCKFORD

PLANNING AND ZONING APPLICATION

6031 Main Street Rockford, MN 55373

763-477-6565 763-477-4393 FAX

1. Property location (address and legal description): ______________________________

______________________________________________________________________

______________________________________________________________________

2. Applicant name (Responsible person if corporation; agents must provide WRITTEN authorization by property owner): ______________________________________________________________________

Mailing Address: ______________________________________________________________________

Phone (home): ____________________ Phone (business): ______________________

3. Owner name (if different from applicant): ______________________________________

4. Action requested: Required Fee at Time of Application:

_____ *Preliminary Plat $10/acre or $500, whichever is greater

_____ PUD Concept Plan $200

_____ *Final Plat None

_____ Conditional Use Permit $100 Residential/$300 Commercial

_____ Site Plan $200

_____ Variance $200

_____ Rezoning $300

_____ Land Alteration $200

_____ Land Consolidation/Division $300

_____ Comprehensive Plan Amendment $300

_____ Permitted Home Occupation $ 30

_____ Standard Detail Plates $75

_____ Annexation $100 for property less than 2 acres the fee increases with larger parcels according to the fee required for filing

the annexation with the State Office of Administration.

_____ Other_______________________

*The actions will require a Park Dedication fee paid prior to development.

5. Brief Description of Request (attach additional information if needed): _______________

____________________________________________________________________________

____________________________________________________________________________

I hereby apply for the above consideration and declare that the information and materials submitted

with this application are complete and accurate per city ordinance and policy requirements. I understand

that the application will be placed on the appropriate and legal agenda when it has been reviewed

administratively and has been found to be in order. I understand the normal administrative review period

is up to forty-five (45) days for planning items and up to ninety (90) days for zoning commission items.

__________________________________ ______________________________

Applicant Signature Date

__________________________________ _______________________________

Property Owner Signature Date

App #______ Fee Required:_____ Fee Paid:_____ Receipt No:_____ Staff Initials:_____