Application for Development Review 22-16001LL-)
COMMUNTTY DEVELOPMENT DEPARTMENT
Planning Oivision - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 I Fax: (952\ 227-1'l1O
submitrar Dare: iZ-l .* I ?l'zz-- ec o.r.'
*crTrorcHrr{ttAssril
APPLICATION FOR DEVELOPMENT REVIEW
CC Date 6GDay Review Date:
Section l: Application Type (check all thar apply)
(Reler to tE aryqtiate Adicatbn c,,1€*list lo. requiGd subnittal infonrration that nust eannqrry ,J'is a$kztidt)
! Comprehensive Plan Amendment.......
E Conditional Use Permit (CUP)
........... $600
D Single-Family Residence s32s
$500E AI orhers.................
E lnterim Use Permit (lUP)
E ln coniunction with Single-Family Residence.. $325E At orhers............... $500
E Rezoning (REZ)
E Planned Unit Development (PUD).
E Minor Amendmenl to existing PUD
E Att others........
! Sign Plan Review..........
D Site Ptan Review (SPR)
E Administrative.........
$1 50
..... $100
..... $500
E Subdivision (suB)
E Create 3 lots or less ......
fr Ptoptty Ul,:lers' List within 500' lciry to generate e{ter pre.applicaftr rneeting} .......i$L! Escrow for Recording Documents (check all that
E Conditional Use Permit
app!lv)...........................
lnlerim Use Permit
E Vacation ! Variance
E Metes & Bounds Subdivision (2 deeds) E Easements (- easements)
E Create over 3 |ots.......................$600 + $15 per lot(_ lots)
fflrtetes & Bounds (2 lots)..E Consolidate Lots...............................
$1s0
$275
$3 oer address
addresses) t tfL { '3t,
......................... $50 per document
E Site Plan Agreement
n We and Alteration Permit
?",71"i8, t"qb
$300
... $300
... $150
....... $750
....... $100
....... s500
! Administralive Subd. (Line Adjustment).......... $1 50
E Final Plat + $15 per |ot........................ $700--(lncludes $450 escrow for attomey cosls)
'Additbnal escrov, may b€ required lor other applications
lhroogh ltle developn€nt coa{r4i
E Vacation o, EasementyRight-of-way (VAC)........ $300
(Additional recording fees may appty)
! Variance (VAR)...........................
E Wetland Alteration Permit (WAP)
$200
D Single-Family Residenc€.........
Ei nrr otn"o.-.1... -. -.--..- -.........:....
$200
$500
... s200
D Commercial/lndustrial Districts'.....
Plus $10 per 1,0OO square feet ol building area:(_ thousand square leet)E zoning Appeal.
'lnclude number o{ e!S!!!e employees:
'lnclude number of @E employees:E Zoning Ordinance Amendment (ZOA)..
E Residential Districts............. $5oo
Plus $5 per dwelling unit (_ units)
Q[E: When rnultiple qplications are prccesseal coocurently, tlE approyia'€ ree sha b charyed lot e-ech epplication.
Notilication Sign (cty to insralr and remove)
Section 2: Required lnformation
Description of Proposal:
Property Address or Localion:
Parcel #:
l,l\o L"t&n t*
Legal Description
Total Acreage Wetlands Present?EYes E tto
Present Zoning:Requested Zoning
Present Land Use Designation:?t ,,1^J*t Requested Land Use Designation
l. t1
Existing Use ol Property:
fl Check box if separate narrative is attached
ti-*M-
Section 3: Property Owner and Applicant lnformation
APPLICANr OTHER THAN PROPERTY OWNER: ln signing this application, l, as applicanl, represent to have obtained
authorization from the property owner to file this application. I agree to be bound by conditions ot appioval, subject only to
the right to object at the hearings on the application or during lhe appeal period. lf this applicalion has not been signed by
the property owner, I have attached separate documentation ol full legal capacity to Iile the application. This application
should be processed in my name and I am the party whom the City should contact regarding any matter pertaining lo this
application. I will keep mysell informed o, the deadlines for submission of material and the progress oI this application. I
funher understand that additional fees may be charged fo; consulting fees, leasibility studies, etc. with an estimale prior to
any authorization lo proceed with the study. I cenify that the intormation and exhibits submined are true and correct.
Name: a-{^B*t 'rt-t.+
Address: q o L *Lr,il-Phone
City/Srat€/Zip Cell:
Fax:
Date
612- 3Yr-1- 82<(
Emait: a&.r4ro bt.{G. 6,-*. t . (.,rn
Signalure tL-tq-ZL-
PROPERTY OWNER: In signing this applicalion, l, as property owner, have f ull legal capacity to, and hereby do,
authorize the filing of this application. I understand that conditions of approval are binding and agree to be bound by those
conditions, subject only lo the right to obrect at lhe hearings or during lhe appeal periods. I will keep myself intormed ot
the deadlines lor submission of material and the progress ol this application. I further understand that additionallees may
be charged tor consulting tees, teasibility studies, etc. with an estimate prior to any authorization to proceed with the
study. lcenity that the information and exhibits submined are true and correct.
Name
Addre
+el^,u Contact:Y,{".1^
SS tfoeh^re^r C.cJ-
ce4{:lrrr.iu.J F33i Cell:
Fax:
Date
l!.a-nro- zbbG
Email tlrl (
Signature:lZ- rS-27
PROJECT ENGINEER (if applicable)
Name: lkJ Ep-*Aea- C,v,l Contact W,,* 9*t*/.."-
eddress: P.O Ao*- 28,038 Phone:
City/Statezip:S+ Pa.ll r,l.r... 5SlzB Cell
Fax
'|c'L'- uo -511 f
Email: CrVrl ,rl,d.-.l'rcrJ,.i ( .-'..
*Other Contact lnformation:
E'rcWfty Ownet Email- fl 4ppticanr EmailWEnoineer Emailti ottr""r Emait
Name
Address
city/statezip
Email:
INSTRUCIO S TO APPLICANr: Complete all necessary lorm tields, then select SAVE FORM to save a copy to your
device. PRINT FORM and deliver to city along with required documenls and payment. SUBMIT FORM to send a digital
copy to the city fo, processing.
Section 4: Notification lnformation
Contact:
Phone:
city/statezip:
This application must be completed in full and be typewritlen or clearly printed and must be accompanied by all
inrormation and plans required by applicable City Ordinance provisions. Betore filing this application, reter to the
appropriale Application Checklist and conler with the Planning Deparhent to determine the specific ordinance and
applicable procedural requirements.
A determination of completeness of the application shall be made within 15 business days ot application submittal. A
written notice ol application dericiencies shall be mailed to the applicant within 15 business days ot application.
Who should receive copies of staff repons?