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1. Applicant <br />Address <br />CITY OF COTTAGE GROVE <br />APPLICATION FOR ACCESSORY APARTMENT PERMIT <br />Date Received: <br />Fee: <br />Decision: Grant Deny <br />Notice Mailed: <br />Date Permit Issued: <br />Permit No.: <br />Phone No. <br />2. Legal Description of Property <br />3. Does the,owner occupy this property? <br />4. Attach plans showing all alterations to structure proposed to create accessory <br />apartment and location of four (4) required parking spaces. <br />5. If dwelling uses an on -site sewage disposal system, attach inspection report from <br />a licensed contractor or inspector. <br />6. Acknowledgement or Signature: The undersigned hereby represents upon all of the <br />penalties of law, for the purpose of inducing the City of Cottage Grove to take <br />the action herein requested, that all statements herein are true and that all <br />work herein mentioned will be done in accordance with the ordinance of the <br />City of Cottage Grove, and the laws of the State of Minnesota. <br />Signature Date <br />39 <br />