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CAS-13_2016-02 ASSOCIATED FILE 2016-13COMMUNITY DEVELOPMENT DEPARTMENT Planning Division – 7700 Market Boulevard CITY OF CIMNSEN Mailing Address – P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-1300 / Fax: (952) 227-1110 APPLICATION FOR DEVELOPMENT REVIEW Submittal Date: b': -Z'201 6 PC Date: CC Date: 60 -Day Review Date: Section 1: Application Type (check all that apply) (Refer to the appropriate Application Checklist for required submittal information that must accompany this application) ❑ Comprehensive Plan Amendment... ...................... $600 ❑ Subdivision (SUB) ❑ Minor MUSA line for failing on-site sewers ..... $100 ❑ Create 3 lots or less ........................................$300 El Conditional El Create over 3 lots .......................$600 + $15 per lot Use Permit (CUP) ( lots) ❑ Single -Family Residence................................$325 ❑ Metes & Bounds (2 lots) .................................. $300 ❑ All Others .........................................................$425 ❑ Consolidate Lots .............................................. $150 El Interim Use Permit (IUP) ® Lot Line Adjustment........................................� ❑ Final Plat ❑ In conjunction with Single -Family Residence.. $325 ..........................................................$700 (Includes $450 escrow for attorney costs)' ❑ All Others......................................................... $425 'Additional escrow may be required for other applications ❑ Rezoning (REZ) through the development contract. ❑ Planned Unit Development (PUD) .................. $750 ❑ Vacation of Easements/Right-of-way (VAC)........ $300 ❑ Minor Amendment to existing PUD ................. $100 (Additional recording fees may apply) ❑ All Others......................................................... $500 ❑ Variance (VAR) .................................................... $200 ❑ Sign Plan Review...................................................$150 ❑ Wetland Alteration Permit (WAP) ❑ Site Plan Review (SPR) ❑ Single -Family Residence ............................... $150 ❑ Administrative ..................................................$100 ❑ All Others ....................................................... $275 ElCommercial/Industrial Districts' ......................$500 ❑ Zoning Appeal $100 Plus $10 per 1,000 square feet of building area: ...................................................... ( thousand square feet) 'Include number of existinc employees: ElZoning Ordinance Amendment (ZOA)................. $500 Indude number of new employees: Residential Districts ......................................... ElResidential $500 When multiple applications are processed concurrently, —appropriate Plus $5 per dwelling unit (_ units) The th fee shall be charged for each application. ❑ Notification Sign (City to install and remove)...................................................................................................................... $200 ❑ Property Owners' List within 500' (City to generate after pre -application meeting) .................................................. $3 per address (— addresses) ❑ Escrow for Recording Documents (check all that apply) ......................................... ....... $50 per document ❑ Conditional Use Permit ❑ Interim Use Permit ❑ Site Plan Agreement ❑ Vacation ❑ Variance ❑ Wetland Alteration Permit ❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements (_ easements) TOTAL FEE: 1$d Section 2: Required Information Description of Proposal: Property Address or Location: —12 SO Grtctt •P ct;%n 5 $ Iy d, C i,\a vtl tct s i e vt , pA N S 5 3 17 Parcel #: a 5 02 4 0'R 10 Legal Description: so e of +`rdl Total Acreage: '2--75 Wetlands Present? J�j Yes ❑ No Present Zoning: Select One A2 - Aav:cv 4vya t Requested Zoning: Select One 5'q wt e Present Land Use Designation: Select OneLp ,• � r; Requested Land Use Designation: Select One `�' Existing Use of Property: S %v^l-e 'F %m i ) Y*s -A a .AN& 1 ❑ Check box is separate narrative is attached. —Section 3: Property . Applicant APPLICANT OTHER THAN PROPERTY OWNER: In signing this application, I, as applicant, represent to have obtained authorization from the property owner to file this application. I agree to be bound by conditions of approval, subject only to the right to object at the hearings on the application or during the appeal period. If this application has not been signed by the property owner, I have attached separate documentation of full legal capacity to file the application. This application should be processed in my name and I am the party whom the City should contact regarding any matter pertaining to this application. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: Contact: Address: Phone: City/State/Zip: Cell: Email: Fax: Signature: Date: PROPERTY OWNER: In signing this application, I, as property owner, have full 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 to the right to object at the hearings or during the appeal periods. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: Paul D d CA[o I L IPauloc, Contact: Foo, D pavlSar. Address: 32 5 O G c -t41 hA tN 5 R IVa Phone: 9 5 2- q Sf 4 2695 City/State/Zip: I MN S S i 11 - 5s 4 4 1 Cell: Saw+ t Email: au l- d, au I so"C� warn (. co, Fax: Signature: Date: 2 •a- -2 01 6 This application must be completed in full and must be accompanied by all information and plans required by applicable City Ordinance provisions. Before filing this application, refer to the appropriate Application Checklist and confer with the Planning Department to determine the specific ordinance and applicable procedural requirements and fees. A determination of completeness of the application shall be made within 15 business days of application submittal. A written notice of application deficiencies shall be mailed to the applicant within 15 business days of application. PROJECT ENGINEER ('If applicable) Name: Contact: Address: Phone: City/State/Zip: Cell: Email: Fax: Section 4: Notification Information Who should receive copies of staff reports? 'Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: ❑ Applicant Via: ❑ Email ❑ Mailed Paper Copy Address: ❑ Engineer Via: [:]Email ❑ Mailed Paper Copy City/State/Zip: ❑ Other' Via: ❑ Email ❑ Mailed Paper Copy Email: INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital copy to the city for processing (required). SAVE FORM PRINT FORM SUBMIT FORM COMMUNITY DEVELOPMENT DEPARTMENT CITY OF CHANHASSEN Planning Division - 7700 Market Boulevard Mailing Address - P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-1300 / Fax: (952) 227-1110 0 APPLICATION FOR DEVELOPMENT REVIEW Submittal Date: PC Date: CC Date: 60 -Day Review Date: Section 1: Application Type (check all that apply) (Refer to the appropriate Application Checklist for required submittal information that must accompany this application) ❑ Comprehensive Plan Amendment ......................... $600 ❑ Minor MUSA line for failing on-site sewers ..... $100 ❑ Conditional Use Permit (CUP) $200 ❑ ❑ Single -Family Residence ................................ $325 ❑ All Others ......................................................... $425 ❑ Interim Use Permit (IUP) $275 ❑ ❑ In conjunction with Single -Family Residence.. $325 ❑ ❑ All Others ......................................................... $425 ❑ Rezoning (REZ) ❑ Planned Unit Development (PUD) .................. $750 ❑ Minor Amendment to existing PUD ................. $100 ❑ All Others......................................................... $500 ❑ Sign Plan Review...................................................$150 ❑ Site Plan Review (SPR) ❑ Administrative.................................................. $100 ❑ Commercial/Industrial Districts'......................$500 Plus $10 per 1,000 square feet of building area: ( thousand square feet) Include number of existing employees: Include number of new employees: ❑ Residential Districts ......................................... $500 Plus $5 per dwelling unit (_ units) ❑ Notification Sign (City to install and remove) .......................... ❑ Subdivision (SUB) ❑ Create 3 lots or less ........................................ $300 ❑ Create over 3 lots .......................$600 + $15 per lot ( lots) ❑ Metes & Bounds (2 lots)..................................$300 ❑ Consolidate Lots..............................................$150 Lot Line Adjustment ......................................... $150 Final Plat.......................................................... $700 (Includes $450 escrow for attorney costs)' 'Additional escrow may be required for other applications through the development contract. ❑ Vacation of Easements/Right-of-way (VAC)........ $300 (Additional recording fees may apply) ❑ Variance (VAR) .................................................... $200 ❑ Wetland Alteration Permit (WAP) ❑ Single -Family Residence ............................... $150 ❑ All Others ....................................................... $275 ❑ Zoning Appeal ...................................................... $100 ❑ Zoning Ordinance Amendment (ZOA)................. $500 NOTE: When multiple applications are processed concurrently, the appropriate fee shall be charged for each application. ............................................................................. $200 ❑ Property Owners' List within 500' (city to generate after pre -application meeting) .................................................. $3 per address C— addresses) 8( Escrow for Recording Documents (check all that apply)....................................................................... $50 per document ❑ Conditional Use Permit ❑ Interim Use Permit ❑ Site Plan Agreement ❑ Vacation ❑ Variance ❑ Wetland Alteration Permit ❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements I— easements) TOTAL FEE: Z UC Description of Proposal: Property Address or Location: 125b 6ZgyJ i &G±//v S gLl%D Parcel #: ZS bre 4 09 10 Legal Description: � /t4tCMC9 Total Acreage: 4. !D_ Wetlands Present? -Kyes ❑ No Present Zoning: Select One Requested Zoning: Select One Present Land Use Designation: Select One Requested Land Use Designation: Select One Existing Use of Property:-1205rsc-37 ) A 4 ❑ Check box is separate narrative is attached Section 3: Property , Applicant APPLICANT OTHER THAN PROPERTY OWNER: In signing this application, I, as applicant, represent to have obtained authorization from the property owner to file this application. 1 agree to be bound by conditions of approval, subject only to the right to object at the hearings on the application or during the appeal period. If this application has not been signed by the property owner, I have attached separate documentation of full legal capacity to file the application. This application should be processed in my name and I am the party whom the City should contact regarding any matter pertaining to this application. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: oXw LLC Contact: el L-L Loop M4+J Address: /GOU GWtJG A %AZ- 0- # YSO Phone: City/State/Zip: 60 tJ)e3J t14 ",tr� Me--SS Y A 7 Cell: 6 1 2 -� Zo-1- — C 6 9 Z Email: b j 11 C p (6 V V% . CA Fax: Signature: Date: '9JC-/J V PROPERTY OWNER: In signing t application, 1, as property owner, have full 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 to the right to object at the hearings or during the appeal periods. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: 7AvL # (ZA&ut �AJLSoa Contact: ?AYLt PAN-S 0f-lk Address: 925.0 6yt-.#W- 44145 dl-VIX Phone: City/State/Zip: CI K4 f; S 311 Cell: Ic - YS M - Z-b 9 Email: Fax: Signature: Date: This application must be completed in full and must be accompanied by all information and plans required by applicable City Ordinance provisions. Before filing this application, refer to the appropriate Application Checklist and confer with the Planning Department to determine the specific ordinance and applicable procedural requirements and fees. A determination of completeness of the application shall be made within 15 business days of application submittal. A written notice of application deficiencies shall be mailed to the applicant within 15 business days of application. PROJECT ENGINEER ('If applicable) n - _ Name: AZJAj.+T P_w6/N�?"2/NS Contact: (4�IQ1!_ Nty5Cb+ Address: eAR1L /ii x 5. -P-3a0 Phone: (p1'Z -7S$- 3oko City/State/Zip: Z&AIpARULI y/S Cell: Email:� n��(iV SL��iA al� � ay.�t — %.nG • C—ow-� Fax: Section 4: Notification Information Who should receive copies of staff reports? *Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: ❑ Applicant Via: ❑ Email ❑ Mailed Paper Copy Address: ❑ Engineer Via: ❑ Email ❑ Mailed Paper Copy City/State/Zip: ❑ Other* Via: ❑ Email ❑ Mailed Paper Copy Email: INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital copy to the city for processing (required). SAVE FORM PRINT FORM SUBMIT FORM CITY OF CHANHASSEN P 0 BOX 147 CHANHASSEN MN 55317 08/22/2016 10:04 AM Receipt No. 00324523 CLERK: AshleyM PAYEE: Providence 55 LLC 6102 Olson Memorial Highway Golden Valley MN 55422- 9250 Great Plains Blvd ------------------------------------------------------- Lot Line Adjustment 150.00 Overpayment -Refund 50.00 Total Cash Check 1128 Change 200.00 0.00 200.00 0.00 ea PARCEL A PARCELIC %. N89'56'30'W 0 32.00 d w S89'53'00'E i 16.00 S89'53'00"E N [NC 0' AW SW /114 (Y----- /NF SW V. OF SCC I1 611.75• I y Wm+°a• ew tiv 'K \ 1�� Q W I g N mm RE1 6i, Ill SdNNWESI 570.40 �i� w2rmdr-A� nii Lwc a-.-�:: GC'6)FY4q'S _ N R ' 2E N(`I ♦ ♦ ♦ ♦ IQ S89°5000'E 319.24 % SOB°t5428'W/ --30.t °40.3 ♦ ♦ ♦ y a ♦ a �••, S89'5,700E 414.98 -' w ♦ ♦ �' g212 I m \_ s �K m 1Ne Nwen1 �6 I FEET T / p /ECl a mr SN //. CE Ilk SW //4 0' SEC 24 :7 / I 2 ♦ ♦ . . ♦ f . . ♦ ♦ N ♦ a ♦ « ♦ ♦ a . a 4A tQ♦ 4 ♦ ♦ . ♦ ♦ ♦ ♦ ♦ ♦ yj .. / •� W ♦♦♦♦faYPARCEL ons .+E3+++++ o ¢ W i ♦ a♦♦♦f♦«f♦♦« a ' b♦ ♦. ♦ ♦ ♦ ♦ a♦ �f \// '-, O " ♦ C \ / .a . ., a♦♦g'g ♦E♦ -♦ . ♦ « . . « « ♦ mss2.1 --241.2& . .... .. ... .. PARCELIC %. N89'56'30'W 0 32.00 d w S89'53'00'E i 16.00 PARCEL AREA TABLE: PARCEL A = 1.03 AC PARCEL B = 1.25 AC PARCEL C = 2.71 AC TOTAL = 4.99 AC I ---NE sX/N/WESI CCNNE6 a INC "r "1H Lair °` I amoeIN 0 50 W 200 WESI 22LN l T G' INE N m mm RE1 6i, Ill SdNNWESI �yy a JAW mw�C N R ' 2E N(`I ♦ ♦ ♦ ♦ Q Qy "I ♦ ♦ ♦ y a ♦ a W ��+Sb��d I Q616I(W, MCI 2. w ♦ ♦ �' I ♦ ♦ ✓ ♦ 4 ♦ ♦ ♦ SCALE IN FEET T nO ♦ f ♦ ♦ ♦ ♦ ♦ VVV' 0 .'♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ :7 / 2 ♦ ♦ . . ♦ f . . ♦ ♦ N ♦ a ♦ « ♦ ♦ a . a 4A tQ♦ 4 ♦ ♦ . ♦ ♦ ♦ ♦ ♦ ♦ yj .. / •� ♦♦♦♦faYPARCEL .+E3+++++ ¢ W i ♦ a♦♦♦f♦«f♦♦« a ' b♦ ♦. ♦ ♦ ♦ ♦ a♦ �f ¢�a`.i '-, ♦ ♦ f ♦♦ a ♦ ♦f ♦a ` ..f♦♦ " ♦ C .a . ., a♦♦g'g ♦E♦ -♦ . ♦ « . . « « ♦ mss2.1 --241.2& . .... .. ... .. PARCEL AREA TABLE: PARCEL A = 1.03 AC PARCEL B = 1.25 AC PARCEL C = 2.71 AC TOTAL = 4.99 AC I ---NE sX/N/WESI CCNNE6 a INC "r "1H Lair °` I amoeIN 0 50 100 200 WESI 22LN l T G' INE N m mm RE1 6i, Ill SdNNWESI I M ..26 l r ix INE "?NWESI / OtNWI 6 M SOfNNWESI IX 127R SZCI 24 C[MWIEW P' I!6' SIXNMWESI I Q616I(W, MCI 2. I SCALE IN FEET wig g6 W.. 6, 9250 GREAT PLAINS BOULAVARD EL SVlil.OM BLL PARCEL SPLIT - SHEET 1 OF 4 SHEETS CHANHASSEN, MINNESOTA 1PV�6 r-iao• Mliant Engineering, hc. 233 Dark Ave S. 51e 300 Minneapolis, MN 5SC15 612358.3080 MIIN 612158.3099 FN% ww♦a6ant3nc.. ♦ I ♦ Ti GONYEA 5 � � �. ��''P,•P \ � �+�. % i�p � I . ♦ � xaMesaueeooEarws 0z 1 r � � pe Po l rw ,mow ,•%A° ��os [t� i C I�� ew°Oo.°x".`,iueP e. r iC �- ^ iI `�. .A / N \\\ jam. t' _ .0 ♦♦ ALLIANT �% vPoeM �\ _ •tl"� .v`1_ C > •as r.n e.a,saoo ll/ J.IN PA N Mem l i B F O � it � �, \ /,'.' •m I \`� �. g wo oPM..a.,.i .. \`•��" ,,' r P1PVM� �/�� \ � •.. � _ Jf RMM M • \ �'•O� P'P• QC: - Savmv Pan G I I ' �nwwf� / i. - C - � J � _ _ _ � L �/i i � . xr ueex n •a A A � � ; v •mun gw+wu/�� LEGEND:IOT LINI l , , p , i NOS •OP /aY{pfR e[aM1� y ' 9p vn 9 0133 i r _ T . � I 1111 a,iry M wu>en nb[m O wzuur, / C' .alu wr m n16sYF. r 1 a uenn -w a me.rv.J xxzs _ TYPICAL LOT;DETAIL Vwwn r m a �r 7 e \� i i ,o nmrv. pUIlOIF i aunm r� our:m o u GOP AEV �\N f��s1 0. ` `{n01 G�eiPOCSW P'NO�GIO/P LEGEND: x GONYEA NOOLDEx6 —0-1IUIIAO�1"T". WIFE PLAN DATA TM.x wN amine. m f10 e / ry n:nn mumNn ¢e w[ILVIOI AII10111 (ifA AM ' me a wwe) I t M /l >me ure caenx n rwc v.nv .[ s Ia.A v npenV i r _ T . � I 1111 a,iry M wu>en nb[m O wzuur, / C' .alu wr m n16sYF. r 1 a uenn -w a me.rv.J xxzs _ TYPICAL LOT;DETAIL Vwwn r m a �r 7 e \� i i ,o nmrv. pUIlOIF i aunm r� our:m o u GOP AEV �\N f��s1 0. ` `{n01 G�eiPOCSW P'NO�GIO/P LEGEND: x GONYEA NOOLDEx6 —0-1IUIIAO�1"T". Date Received CARVER COUNTY Taxpayer Services Department Government Center - Administration Building 600 East 4th Street Chaska, MN 55318-2102 Phone (952) 361-1910 Fax (952) 361-1919 Application to Combine Real Estate Parcels Per MN Statute 272.46 the county auditor, upon written application of any person, shall for property tax purposes only, combine legal descriptions of contiguous parcels to which the applicant(s) hold title. In order to be combined, the following requirements must be met: • Receipt of completed form by owner or designated representative • Based upon deeds of record, parcels must be of the same (identical) ownership • Parcels must be contiguous • Parcels must be located in same unique taxing districts (TAG) • Current year and delinquent taxes must be paid on each parcel • If parcels are in a Tax Increment Financing District (TIF), they must be located in the same TIF district • If special assessments are not paid on all parcels, the city/township would need to recertify the special assessments for the new parcel CAUTION Parcels that have been combined cannot be subdivided again without local municipality approval. If located in a township, Carver County Land Management Office must also approve the subdivision. Combined property tax will be reflected on next year's tax statement Owner(Applicant)Name, Foxwoo--,e, I-LLf Address: /000 -BzV„�. /I VE N. , '0�il'to o Phone Number: (o 1 Z — ZoZ - 0(- 9 Z 6oL. VAu.ry . M) 5 -'Y -X7 Parcels to be combined: SEC-- ftrlf7ctf&T' ,, Signature: Date. For Office Use Only: Approved Denied By: Reason Denied: C:\Users\Bill\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\OD5N9R5F\Administrative subdivision Application to Combine Real Estate Parcels.doc PROVIDENCE 55 LLC BRIDGEWATER BANK 6102 OLSON MEMORIAL HIGHWAY, GOLDEN VALLEY, MN. 5542 PAY TO THE ORDER OF City of Chanhassen Twn Hundred and 001100""" 8/2/2016 {'200.00 1128 DOLLARS City of Chanhassen PO Box 147 Chanhassen, MN 55317 E m MEMD I l` P 19E41D� AUT ORIZED SIGNANRE 11'OOL128116 i:09LOL7S231: 8302S2L II' PROVIDENCE 55 LLC 1128 City of Chanhassen Original Amt. Balance Due 8/2/2016 Discount Payment Date Type Reference 200.00 200.00 200.00 8/2/2016 Bill Lot Line Adj Check Amount 200.00 200.00 Bridgewater Bank T+fi PAY TO THE ORDER OF ------__-- BMO HARRLS SANKMA---- ► 671000288 FOR DEPOSIT CITY OF CHANHASSEN �045�'j4 v NP ,:COPAR. FEATURES LISTED BELOW EXCEED INDUSTRY STANDARDS PARCEL A 12 h1 0Rp 1lk \nAWD / �nAWL o� g� Z PARCEL C N L.E 6 THE 5w i/4 t ------ THC 5W l/r OC SEC 14 I V v J l N 4 S89°53'00'E 611.75 570.40 6o wt r rocwE-cr-war ZlWIl— f' 44EaT aaM's B[l9. S89°5,700'E 319.24 ;' N08d54'28'E/ S89°53.00'E 414.98 —" 30..,1/J6 W 1'._ S tri � THE NCNTH JO I I {LET TM114 LV ]M 11 / sw 214 4144 eF .uC W O O O cn ,__N89°56'30"W 0 32.00 PARCEL AREA TABLE: 0 h w PARCEL A = 1.03 AC p PARCEL B = 1.25 AC N o PARCEL C = 2.71 AC ti S89'53'00"E r 16.00 TOTAL = 4.99 AC w �G n r +oa♦ o.{i + + N 3Q� O +i +ry�♦ a M1 ♦ ! w hu ll ytll tf .y♦ ♦ ♦ N rya + a + + f N + a + i/+ + + a♦+ p p / + + ♦ O a ++a a + ♦ +!+ + a♦ - 2 + a a + + a + p# .�• 0 'Y++a+++a+.++++++++++++,R ♦++++++++++♦+, + ++ a lye♦ +� fy+A�+ ++^µ♦ a M - ,u A 4 a.O+ N CEL ! W ♦ 4 . +/�F+++ FR 4 + f++ ♦/+ 4 f ♦ + + 4 + 4 ($ ^Q # a # a �n'+F++ t i if♦ 4+f 4. + f+♦ Nqq�y +++1'E+ + + r + + + 44f]7 4 + ♦ ♦ # ♦ ♦ i++++++++++++++ +� #++ ♦ +a# ♦ + 4 t # + a ++ vt— N89°5,700'W 271.79 'THE Sd/MI r C091Y8 OF 1HE -THE S rH (INE OC THE NORTH wsr 2A" ?ET OE T TIORIH X228 CLOT t THE SOUTHWEST Ny 762.IB TEST � > 9X MH r [ TER CE THE SOUTHWEST E - / p/ rR C THE SOUTHWEST O TER. SECrK N OWBTEN, . CT 24 lax 0 50 100 200 SCALE IN FEET Deeign R. 'wiro DnecWM By. re 9250 GREAT PLAINS BOULEVARD avant engineering. inc. 236 pal Ave S, Ste' Dwg IWnm dawn Bp ruuxi sttit.Dwc 6u PARCEL SPLIT - SHEET 1 OF 4 SHEETS Minneapolis, MN 55615 CHANHASSEN, MINNESOTA 612.758.9080 W14 612.758.3090 Fria D°" SCO1e1 7/27/16 www.armt-inc.00m CARVERCOUNTY RECORDER/REGISTRAR OF TITLES DOCUMENT COVER SHEET PID# 25.02 1 Dgla No delinquent taxes and transfer entered Pertificate of Real Estate Value ) Fled ( ) Not Required V# GI2201 114+ 01 2016— Lau Davies Carver ntyAuditorTreasurer Dy Deputy DOCUMENT Document No. A632786 OFFICE OF THE COUNTY RECORDER CARVER COUNTY, MINNESOTA Certified Reoorded on -August 29, 2016 1:45 PM Fee: $48.00 1111111111111111111 632786 TITLE: WARRANTY DEED DOCUMENT DATE: AUGUST 22, 2016 DOCUMENT NAMES: PAUL D. PAULSON CAROL L PAULSON David Frischmon County Recorder WARRANTY DEED STATE DEED TAX DUE HEREON: $ 5-7-7,50 eC4 J .g- 55 3 tp (P cj Date: w!bv4 } 22- 12016 FOR VALUABLE CONSIDERATION, Paul D. Paulson and Carol L. Paulson, husband and wife, Grantor, hereby conveys and warrants to the Foxwood, LLC, a Minnesota limited liability company, Grantee, real property in Carver County, Minnesota, legally described as follows: All that part of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota lying westerly and northerly of a line described as follows: Commencing at the southwest comer of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 33.10 feet; thence North 00 degrees 06 minutes 15 seconds East 294.17 feet; thence North 05 degrees 23 minutes 57 seconds East 82.32 feet; thence North 09 degrees 18 minutes 39 seconds East 61.69 feet; thence North 00 degrees 02 minutes 05 seconds West 131.89 feet; thence North 42 degrees 52 minutes 25 seconds East 108.80 feet; thence North 71 degrees 40 minutes 30 seconds East 82.12 feet to a point on the south line of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter; thence South 89 degrees 53 minutes 00 seconds East 414.98 feet along said south line to the westerly right-of-way line of Great Plains Boulevard; thence North 08 degrees 54 minutes 28 seconds East along said westerly right-of-way line a distance of 30.36 feet to the North line of the Southwest Quarter of the Southwest Quarter of said Section 24 and said line there terminating. 0 All that part of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota tying southerly of a line described as follows: Commencing at the southwest comer of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 164.26 feet; thence North 44 degrees 34 minutes 08 seconds East 123.28 feet; thence North 76 degrees 30 minutes 32 seconds East 104.65 feet to the east line of the West 271.79 feet of said Southwest Quarter of the Southwest Quarter and said line there terminating. Custom Nome 6idrs. Tine 10850 Old County Road 15 Plymouth, MN 55441 together with all hereditaments and appurtenances belonging thereto, subject to the following exceptions: None. X The Seller certifies that the Seller does not know of any wells on the described real property. ~_ A well disclosure certificate accompanies this document or has been electronically filed. (If electronically filed, insert WDC number: ) _ Seller certifies that the status and number of wells on the described property have not changed since the last previously filed well disclosure certificate. STATE OF MINNESOTA ) ) SS COUNTY OF HENNEPIN ) The foregoing was acknowledged before me this V -day of August, 2016, by Paul D. Paulson and Carol L. Paulson, husband and wife. Notarial Stamp 1#110,1:11RA�M'OT"" li6lpnnesdawE _-4-91,7020 This instrument was drafted by: Custom Home Builders Title, LLC 10850 Old County Road 15 Plymouth, MN 55441 1 Si&atu& of person taking acknowledgment Tax statements for the real property described herein should be sent: Foxwood, LLC 1000 Boone Avenue North, Suite 400 Golden Valley, MN 55427 0 .5j Deed Tax "oft $ J?n. I--2L-L(Date) — paid on 2L L(Date) Conservation Fee Paid Laurie Davies Carver Gounty Auditor -Treasurer City Clerk's Certification Pursuant to M.S. 272.162 The undersigned hereby certifies: (Check one of the following:) That City subdivision regulations do not apply to this instrument. That the subdivision of land affected by this instrument has been approved by the goveming body of the City of Chanhassen. That municipal restrictions on the filing and recording of this instrument have been waived by a resolution of the governing body of the City of Chanhassen. That this instrument does not comply with municipal subdivision restrictions and the affected land and its assessed valuation should not be divided by the County COMMUNITY DEVELOPMENT DEPARTMENT Planning Division - 7700 Market Boulevard Mailing Address - P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-1300 / Fax: (952) 227-1110 CITY OFCEAN9ASSEN APPLICATION FOR DEVELOPMENT REVIEW Submittal Date: %--Aa-20110 PC Date: CC Date: 60 -Day Review Date: (Refer to the appropriate Application Checklist for required submittal information that must accompany this application) ❑ Comprehensive Plan Amendment ......................... $600 ❑ Subdivision (SUB) ❑ Minor MUSA line for failing on-site sewers ..... $100 ❑ Create 3 lots or less ........................................$300 ❑ Conditional El Create over 3 lots.......................$600 + $15 per lot Use Permit (CUP) ( lots) ❑ Single -Family Residence ................................ $325 ❑ Metes & Bounds (2 lots) .................................. $300 ❑ All Others......................................................... $425 ❑ Consolidate Lots .............................................. $150 ❑ Interim Use Permit (IUP) ® Lot Line Adjustment ........................................ ❑ Final Plat 1 ❑ In conjunction with Single -Family Residence.. $325 ..........................................................$700 (Includes $450 escrow for attorney costs)` ❑ All Others......................................................... $425 *Additional escrow may be required for other applications ❑ Rezoning(REZ) through the development contract. ❑ Planned Unit Development (PUD) .................. $750 ❑ Vacation of Easements/Right-of-way (VAC)........ $300 ❑ Minor Amendment to existing PUD ................. $100 (Additional recording fees may apply) ❑ All Others......................................................... $500 ❑ Variance (VAR) .................................................... $200 ❑ Sign Plan Review ................................................... $150 ❑ Wetland Alteration Permit (WAP) ❑ Site Plan Review (SPR) ❑ Single -Family Residence ............................... $150 ❑ Administrative ..................................................$100 ❑ All Others ....................................................... $275 ❑ Commercial/Industrial Districts' ......................$500 ❑ Zoning Appeal :.............. $100 Plus $10 per 1,000 square feet of building area: .............. -....................... (_ thousand square feet) 'Include E]Zoning Ordinance Amendment (ZOA)................. $500 number of ex' in employees: Include number of new employees: ❑NOTE: Residential Districts ......................................... $500 When multiple applications are processed concurrently, Plus $5 per dwelling unit (_ units) the appropriate fee shall be charged for each application. ❑ Notification Sign (City to install and remove)...................................................................................................................... $200 ❑ Property Owners' List within 500' (City to generate after pre -application meeting) .................................................. $3 per address ( addresses) ❑ Escrow for Recording Documents (check all that apply)....................................................................... $50 per document ❑ Conditional Use Permit ❑ Interim Use Permit ❑ Site Plan Agreement ❑ Vacation ❑ Variance ❑ Wetland Alteration Permit ❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements (—easements) TOTAL FEE: 1 Sd Description of Proposal: Property Address or Location: 12 SO Gera+ f )Cl;%n S $ I V d, C Hav,tiu $ f -evi t M N S 5 3 11 Parcel #: a S O2 4 0 S 1 O Legal Description: set of 4d o.41 Total Acreage: 2• -►5 Wetlands Present? J91 Yes ❑ No Present Zoning: Select One A2- A, ir� cv"va t Requested Zoning: Select One Present Land Use Designation: SelectOne? � lq Requested Land Use Designation: Select One Existing Use of Property: S twyl-e 4tnn I lh ❑ Check box is separate narrative is attached. Section •.' . Applicant APPLICANT OTHER THAN PROPERTY OWNER: In signing this application, I, as applicant, represent to have obtained authorization from the property owner to file this application. I agree to be bound by conditions of approval, subject only to the right to object at the hearings on the application or during the appeal period. If this application has not been signed by the property owner, I have attached separate documentation of full legal capacity to file the application. This application should be processed in my name and I am the party whom the City should contact regarding any matter pertaining to this application. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: Contact: Address: Phone: City/State/Zip: Cell: Email: Fax: Signature: Date: PROPERTY OWNER: In signing this application, I, as property owner, have full 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 to the right to object at the hearings or during the appeal periods. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: Pout D d Ca -to 1 L Pauls.. Contact: �aul D PAVlS6h Address: `i2 5 0 Gi-er l hv, t" S $ Iva Phone: 9 5 z q r, 4 2698 City/State/Zip: C Ina„�nes s rM I J �1J 5 5 3 1 1- 5 4 4 1 Cell: Sa W t Email: PcLu l- d. au Fax: Signature: v , t�l�, i AV� �7 Date: q'2 i--2.016 This application must be completed in full and must be accompanied by all information and plans required by applicable City Ordinance provisions. Before fling this application, refer to the appropriate Application Checklist and confer with the Planning Department to determine the specific ordinance and applicable procedural requirements and fees. A determination of completeness of the application shall be made within 15 business days of application submittal. A written notice of application deficiencies shall be mailed to the applicant within 15 business days of application. PROJECT ENGINEER (if applicable) Name: Contact: Address: Phone: City/State/Zip: Cell: Email: Fax'. Section 4: Notification Information Who should receive copies of staff reports? 'Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: ❑ Applicant Via: ❑ Email ❑ Mailed Paper Copy Address: ❑ Engineer Via: []Email ❑ Mailed Paper Copy City/State/Zip: ❑ Other' Via: ❑ Email ❑ Mailed Paper Copy Email: INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital copy to the city for processing (required). SAVE FORM PRINT FORM SUBMIT FORM COMMUNITY DEVELOPMENT DEPARTMENT CITY OF CgANgASSFN Planning Division – 7700 Market Boulevard Mailing Address – P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-1300 / Fax: (952) 227-1110 APPLICATION FOR DEVELOPMENT REVIEW Submittal Dale: PC Date: CC Date: 60 -Day Review Date: Section 1: Application Type (check all that apply) (Refer to the appropriate Application Checklist for required submittal information that must accompany this application) ❑ Comprehensive Plan Amendment ......................... $600 ❑ Minor MUSA line for failing on-site sewers ..... $100 ❑ Conditional Use Permit (CUP) ❑ Single -Family Residence ................................ $325 ❑ All Others ......................................................... $425 ❑ Interim Use Permit (IUP) ❑ In conjunction with Single -Family Residence.. $325 ❑ All Others ......................................................... $425 ❑ Rezoning (REZ) ❑ Planned Unit Development (PUD)..................$750 ❑ Minor Amendment to existing PUD ................. $100 ❑ All Others......................................................... $500 ❑ Sign Plan Review...................................................$150 ❑ Site Plan Review (SPR) ❑ Administrative.................................................. $100 ❑ Commercial/Industrial Districts'......................$500 Plus $10 per 1,000 square feet of building area: thousand square feet) 'Include number of existin employees: 'Include number of new employees: ❑ Residential Districts ......................................... $500 Plus $5 per dwelling and (— units) ❑ Subdivision (SUB) ❑ Create 3 lots or less ........................................ $300 ❑ Create over 3 lots.......................$600 + $15 per lot (_ lots) ❑ Metes & Bounds (2 lots)..................................$300 ❑ Consolidate Lots..............................................$150 Lot Line Adjustment.........................................$150 FinalPlat ..........................................................$700 (Includes $450 escrow for attorney costs)' 'Additional escrow may be required for other applications through the development contract. ❑ Vacation of Easements/Right-of-way (VAC)........ $300 (Additional recording fees may appty) ❑ Variance (VAR) .................................................... $200 ❑ Wetland Alteration Permit (WAP) ❑ Single -Family Residence ............................... $150 ❑ All Others ....................................................... $275 ❑ Zoning Appeal ...................................................... $100 ❑ Zoning Ordinance Amendment (ZOA)................. $500 NOTE: When muttlple applications are processed concurrently, the appropriate fee shall be charged for each application. ❑ Notification Sign (city to install and remove)...................................................................................................................... $200 ❑ Property Owners' List within 500' (city to generate after pre -application meeting) .................................................. $3 per address (— addresses) gf Escrow for Recording Documents (check all that apply)....................................................................... $50 per document ❑ Conditional Use Permit ❑ Interim Use Permit ❑ Site Plan Agreement ❑ Vacation ❑ Variance ❑ Wetland Alteration Permit ❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements( easements) TOTAL FEE: z 00 Section -2: Required Information Description of Proposal: Property Address or Location: '72 Sa&s),17 - Plir/N S 94AII Parcel #: ZS b re V 0'2) 0 Legal Description: 4M4dc tt t% Total Acreage: 4." — Wetlands Present? I<Yes ElNo Present Zoning: Select One Requested Zoning: Select One Present Land Use Designation: Select One Requested Land Use Designation: Select One Existing Use of Property: TLCSratlrJ lA� ❑ Check box is separate narrative is attached. Section 3: Property .. APPLICANT OTHER THAN PROPERTY OWNER: In signing this application, I, as applicant, represent to have obtained authorization from the property owner to file this application. I agree to be bound by conditions of approval, subject only to the right to object at the hearings on the application or during the appeal period. If this application has not been signed by the property owner, I have attached separate documentation of full legal capacity to file the application. This application should be processed in my name and I am the party whom the City should contact regarding any matter pertaining to this application. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. LContact: 61 6r1P'%4+J Name: o)Cw LC ubpu- 0 Address: /boo lJyNE d %Ac Na- # y6c) Phone: City/State/Zip: ;Cl LQ. o J VA tl&!( YN Ste' 41-4 % Cell: A 12- —10"- — a 6 4 Z Email: b 1 re `bV V%#-*-. u' Fax: Signature: Date: V PROPERTY OWNER: In signing tFji application, 1, as property owner, have full 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 to the right to object at the hearings or during the appeal periods. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: 'PAVI # CA4uL PAOf.Soa Contact: �/4yt- PAVG S Of-b Address: 47?" 6M1eytr P&A fij /SC. ✓D. Phone: City/State/Zip: C!g+ IM 311 Cele V8 M - Z-6 9 Email: Fax: Signature: Date: This application must be completed in full and must be accompanied by all information and plans required by applicable City Ordinance provisions. Before filing this application, refer to the appropriate Application Checklist and confer with the Planning Department to determine the specific ordinance and applicable procedural requirements and fees. A determination of completeness of the application shall be made within 15 business days of application submittal. A written notice of application deficiencies shall be mailed to the applicant within 15 business days of application. PROJECT ENGINEER (if applicable) nn -� _ Name:�/tGL/.4wiT 6/.Ne-rz/N6 Contact:�QJ/_ PAw5Icbk Address: ;0 3% Aim /4 VE S . 3a o Phone: t.%Z -752- 30 kb City/State/Zip: )VbVAooAPULI S�N Sr y S Cell: Email: wd,'l'i"C cj( !a.AC- Fax: Section 4: Notification Information Who should receive copies of staff reports? 'Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: ❑ Applicant Via: ❑ Email ❑ Mailed Paper Copy Address: ❑ Engineer Via: ❑ Email ❑ Mailed Paper Copy City/State/Zip: ❑ Other' Via: ❑ Email ❑ Mailed Paper Copy Email: INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital copy to the city for processing (required). SAVE FORM PRINT FORM SUBMR FORM CITY OF CHANHASSEN P O BOX 147 CHANHASSEN MN 55317 08/22/2016 10:04 AM Receipt No. 00324523 CLERK: AshleyM PAYEE: Providence 55 LLC 6102 Olson Memorial Highway Golden Valley MN 55422- 9250 Great Plains Blvd ------------------------------------------------------- Lot Line Adjustment 150.00 Overpayment -Refund 50.00 Total Cash Check 1128 Change 200.00 0.00 200.00 0.00 .=aie N. LM 0` 7/F Ss 114 w S 114 SCC 24 S89053WE 611.75 �' ♦e �� r=i aNis O � -•,,_— 8'00 PARCEL AREA TABLE: 57Q.40 o - nrdbit-� M.r imca_41.35 n PARCELA 2 PARCEL A = 1.03 AC �' OfAF FYAPSAye LU rn PARCEL B = 1.25 AC E _ SB9053WE 319.24 '"�-� PARCEL C S ",,,yyyyyy,,,,,, "181W/ NT1=40 �. % 85% _S89 5300E TOTAL = 4.99 AC S89053'OO"E 414.98 30.t 6212 1--5 ltlC Or lIF /4fNIM .70 I 3. / 114 4 //4 Of SFC N / w rtn o y�n� \ yL^J _. o = v { 65 MIX ♦ hW t ti y ! , b h\' J� h a� ♦ # i 4 ♦♦ ♦♦1/♦1.1♦1♦4 J ♦ hF jp!♦♦ # ♦ 4 a 4 ♦ ♦ ♦y 0 ry a ♦♦ h♦♦♦♦ o ��' .�•♦ ♦ ♦ A. ♦ ♦a!♦. PARCELS ♦ ♦a♦ ♦ h♦♦♦ 4 h 4 a ♦ # W- �/ ♦ # ! ♦ ♦ ♦ ♦ ♦ h a 3. ♦J ♦♦ ♦ i !J J♦+ ♦ �14�f, ♦ ! ! , a ♦ + J --7ic SI]/rNy5i7 ca7w / T a 77r ycs7 zn7s rsr7 a nc epv7H >eue FSF7 r rnr sownycs7 auu7ee ff >K sane.Fs7 aAwl7)k SfC)N1' N N89 -5630'W 8'00 PARCEL AREA TABLE: n 5 2 PARCEL A = 1.03 AC LU rn PARCEL B = 1.25 AC Lo PARCEL C PARCEL C = 2.71 AC % 85% _S89 5300E TOTAL = 4.99 AC 16.00 o = v { 65 MIX ♦ hW t ti y ! , b h\' J� h a� ♦ # i 4 ♦♦ ♦♦1/♦1.1♦1♦4 J ♦ hF jp!♦♦ # ♦ 4 a 4 ♦ ♦ ♦y 0 ry a ♦♦ h♦♦♦♦ o ��' .�•♦ ♦ ♦ A. ♦ ♦a!♦. PARCELS ♦ ♦a♦ ♦ h♦♦♦ 4 h 4 a ♦ # W- �/ ♦ # ! ♦ ♦ ♦ ♦ ♦ h a 3. ♦J ♦♦ ♦ i !J J♦+ ♦ �14�f, ♦ ! ! , a ♦ + J --7ic SI]/rNy5i7 ca7w / T a 77r ycs7 zn7s rsr7 a nc epv7H >eue FSF7 r rnr sownycs7 auu7ee ff >K sane.Fs7 aAwl7)k SfC)N1' N 9250 GREAT PLAINS BOULAVARD ELL PARCEL SPLIT - SHEET 1 OF 4 SHEETS CHANHASSEN, MINNESOTA P�100' 0 50 100 200 SCALE IN FEET M3 Psk AW S. SW 300 WnWp06, MN 55415 612755.9080 I 612758.3008 W w AmA-kla0a0 5 9250 GREAT PLAINS BOULAVARD ELL PARCEL SPLIT - SHEET 1 OF 4 SHEETS CHANHASSEN, MINNESOTA P�100' 0 50 100 200 SCALE IN FEET M3 Psk AW S. SW 300 WnWp06, MN 55415 612755.9080 I 612758.3008 W w AmA-kla0a0 WARRANTY DEED STATE DEED TAX DUE HEREON: $ Date: !!va v -s+ 22 2016 FOR VALUABLE CONSIDERATION, Paul D. Paulson and Carol L. Paulson, husband and wife, Grantor, hereby conveys and warrants to the Foxwood, LLC, a Minnesota limited liability company, Grantee, real property in Carver County, Minnesota, legally described as follows: All that part of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota lying westerly and northerly of a line described as follows: Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 33.10 feet; thence North 00 degrees 06 minutes 15 seconds East 294.17 feet; thence North 05 degrees 23 minutes 57 seconds East 82.32 feet; thence North 09 degrees 18 minutes 39 seconds East 61.69 feet; thence North 00 degrees 02 minutes 05 seconds West 131.89 feet; thence North 42 degrees 52 minutes 25 seconds East 108.80 feet; thence North 71 degrees 40 minutes 30 seconds East 82.12 feet to a point on the south line of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter; thence South 89 degrees 53 minutes 00 seconds East 414.98 feet along said south line to the westerly right-of-way line of Great Plains Boulevard; thence North 08 degrees 54 minutes 28 seconds East along said westerly right-of-way line a distance of 30.36 feet to the North line of the Southwest Quarter of the Southwest Quarter of said Section 24 and said line there terminating. na,11 All that part of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota tying southerly of a line described as follows: Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 164.26 feet; thence North 44 degrees 34 minutes 08 seconds East 123.28 feet; thence North 76 degrees 30 minutes 32 seconds East 104.65 feet to the east line of the West 271.79 feet of said Southwest Quarter of the Southwest Quarter and said line there terminating. together with all hereditaments and appurtenances belonging thereto, subject to the following exceptions: None. _AThe Seller certifies that the Seller does not know of any wells on the described real property. _ A well disclosure certificate accompanies this document or has been electronically filed. (If electronically filed, insert WDC number: ) _ Seller certifies that the status and number of wells on the described property have not changed since the last previously filed well disclosure certificate. P D. Paulson p Carol L. Paulson STATE OF MINNESOTA ) ) SS COUNTY OF HENNEPIN ) The foregoing was acknowledged before me this ? 2 day of August, 2016, by Paul D. Paulson and Carol L. Paulson, husband and wife. Notarial Stamp Garrett Louis Williamson r w"PV* -MYr�* Y/CWAWMEVkaQ W This instrument was drafted by: Custom Home Builders Title, LLC 10850 Old County Road 15 Plymouth, MN 55441 Signature .dg Tax statements for the real property described herein should be sent: Foxwood, LLC 1000 Boone Avenue North, Suite 400 Golden Valley, MN 55427 City Clerk's Certification Pursuant to M.S. 272.162 The undersigned hereby certifies: (Check one of the following:) That City subdivision regulations do not apply to this instrument. That the subdivision of land affected by this instrument has been approved by the governing body of the City of Chanhassen. That municipal restrictions on the filing and recording of this instrument have been waived by a resolution of the governing body of the City of Chanhassen. That this instrument does not comply with municipal subdivision restrictions and the affected land and its assessed valuation should not be divided by the County WARRANTY DEED STATE DEED TAX DUE HEREON: $ Date: siva v a 'V 22- 2016 FOR VALUABLE CONSIDERATION, Paul D. Paulson and Carol L. Paulson, husband and wife, Grantor, hereby conveys and warrants to the Foxwood, LLC, a Minnesota limited liability company, Grantee, real property in Carver County, Minnesota, legally described as follows: All that part of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota lying westerly and northerly of a line described as follows: Commencing at the southwest comer of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 33.10 feet; thence North 00 degrees 06 minutes 15 seconds East 294.17 feet; thence North 05 degrees 23 minutes 57 seconds East 82.32 feet; thence North 09 degrees 18 minutes 39 seconds East 61.69 feet; thence North 00 degrees 02 minutes 05 seconds West 131.89 feet; thence North 42 degrees 52 minutes 25 seconds East 108.80 feet; thence North 71 degrees 40 minutes 30 seconds East 82.12 feet to a point on the south line of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter; thence South 89 degrees 53 minutes 00 seconds East 414.98 feet along said south line to the westerly right-of-way line of Great Plains Boulevard; thence North 08 degrees 54 minutes 28 seconds East along said westerly right-of-way line a distance of 30.36 feet to the North line of the Southwest Quarter of the Southwest Quarter of said Section 24 and said line there terminating. M All that part of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota tying southerly of a line described as follows: Commencing at the southwest comer of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 164.26 feet; thence North 44 degrees 34 minutes 08 seconds East 123.28 feet; thence North 76 degrees 30 minutes 32 seconds East 104.65 feet to the east line of the West 271.79 feet of said Southwest Quarter of the Southwest Quarter and said line there terminating. together with all hereditaments and appurtenances belonging thereto, subject to the following exceptions: None. X The Seller certifies that the Seller does not know of any wells on the described real property. _ A well disclosure certificate accompanies this document or has been electronically filed. (If electronically filed, insert WDC number: ) _ Seller certifies that the status and number of wells on the described property have not changed since the last previously filed well disclosure certificate. PP,41-"aulson Carol L. Paulson STATE OF MINNESOTA ) ) SS COUNTY OF HENNEPIN ) The foregoing was acknowledged before me this'2'day of August, 2016, by Paul D. Paulson and Carol L. Paulson, husband and wife. Notarial Stamp JENNIFER ANPOTTER Na3ry Public•Minnesota MI Cam f�yM yn 31,20x0 This instrument was drafted by: Custom Home Builders Title, LLC 10850 Old County Road 15 Plymouth, MN 55441 fcu�- %64atuh of person taking acknowledgment Tax statements for the real property described herein should be sent: Foxwood, LLC 1000 Boone Avenue North, Suite 400 Golden Valley, MN 55427 City Clerk's Certification Pursuant to M.S. 272.162 The undersigned hereby certifies: (Check one of the following:) That City subdivision regulations do not apply to this instrument. That the subdivision of land affected by this instrument has been approved by the governing body of the City of Chanhassen. That municipal restrictions on the filing and recording of this instrument have been waived by a resolution of the governing body of the City of Chanhassen. That this instrument does not comply with municipal subdivision restrictions and the affected land and its assessed valuation should not be divided by the County Pvq ot. PARENT PARCEL LEGAL DESCRIPTION The West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota EXCEPT That port of the North 330.00 feet of the East 16.00 feet of the West 27L79 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, lying South of the North 180.0 feet, Carver County, Minnesota. AND That part of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter, lying East of the West 271.79 feet thereof and Westerly of the centerline of State Highway No. 10% EXCEPT that port of the Southwest Quarter of the Southwest Quarter of Section 24, Township 116 North, Range 23 West, shown as Parcel 71A on Minnesota Department of transportation Right of Way Plot Numbered 10-19 as the some is on file and of record in the office of the County Recorder in and for Carver County, Minnesota acquired by the State of Minnesota in Document No. A406988, and EXCEPT that part taken by the City of Chanhassen in Final Certificate filed December 18, 2012, as Document No. A567969. AND That part of the South 732.28 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota, lying East of the West 271.79 feet thereof and Westerly of the centerline of State Highway No. I01, described as. That port of the North 180 feet of the East 16.00 feet of the West 28779 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota, lying South of the North 30.00 feet thereof, all in Carver County, Minnesota. Abstract Property. PARCEL A — LEGAL DESCRIPTION All that part of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota lying westerly and northerly of o line described as follows: Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on an assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 707 feet; thence North 28 degrees 09 minutes 47 seconds East 33.10 feet; thence North 00 degrees 06 minutes 15 seconds East 294.17 feet; thence North 05 degrees 23 minutes 57 seconds East 82.32 feet; thence North 09 degrees l8 minutes 39 seconds East 61.69 feet, thence North 00 degrees 02 minutes 05 seconds West 131.89 feet; thence North 42 degrees 52 minutes 25 seconds East 108.80 feet; thence North 71 degrees 40 minutes 30 seconds East 82.12 feet to a point on the south line of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter,- thence South 89 degrees 53 minutes DO seconds East 414.98 feet along sold south line to the westerly right—of—way line of Great Plains Boulevard and said line there terminating. V F WIN o-... e� 9250 GREAT PLAINS BOULAVARD � =PwkAWS.Ste 30o 2 s TTI c aL PARCEL SPLrf - SHEET 2 OF 3 SHEETS Wroapoft. MN 55115 812.855.7050 wa' s CHANHASSEN, MINNESOTA 51215eaog9 FM 7/11/6 I'.im' wnrA ivvt4 tCm PARCEL B — LEGAL DESCRIPTION All that port of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota lying southerly of o line described as follows. Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes 01 seconds East 7.07 feet; thence North 28 degrees 09 minutes 47 seconds East 164.26 feet; thence North 44 degrees 34 minutes 08 seconds East 123.28 feet; thence North 76 degrees 30 minutes 32 seconds East 104.65 feet to the east line of the West 271.79 feet of said Southwest Quarter of the Southwest Quarter and said line there terminating. PARCEL C — LEGAL DESCRIPTION The West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota EXCEPT That port of the North 330.00 feet of the East 16.00 feet of the West 271.79 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, lying South of the North 180.0 feet, Carver County, Minnesota. AND That port of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter, lying East of the West 271.79 feet thereof and Westerly of the centerline of State Highway No. 101, EXCEPT that part of the Southwest Ouorter of the Southwest Quarter of Section 24, Township 116 North, Range 23 West, shown as Parcel 71A on Minnesota Deportment of transportation Right of Way Plot Numbered 10-19 as the some is on file and of record in the office of the County Recorder in and for Carver County, Minnesota acquired by the State of Minnesota in Document No. A405988, and EXCEPT that port taken by the City of Chanhassen in Final Certificate filed December 18, 2012, as Document No. A567969. AND That port of the South 732.28 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota, lying East of the West 271.79 feet thereof and Westerly of the centerline of State Highway No. 101, described as: That port of the North 180 feet of the East 16.00 feet of the West 287.79 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County, Minnesota, lying South of the North 30.00 feet thereof, all in Carver County, Minnesota. omA Op N.n 9250 GREAT PLAINS BOULAVARD Br 6u PARCEL SPLIT - SHEET 3 OF 6 SHEETS CHANHASSEN, MINNESOTA r-ia5• 233r.kw..s.aw3DD MWwPoh. MN 35415 6127589060 NMN 6127669066 w w Amwt*in EXCEPT (PARCEL A) All that port of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota lying westerly and northerly of a line described as follows: Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota; thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on an assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the tine to be described; thence North 55 degrees 30 minutes 0l seconds East 7.07 feet, thence North 28 degrees 09 minutes 47 seconds East 33./0 feet; thence North 00 degrees 06 minutes 15 seconds East 294.17 feet; thence North 05 degrees 23 minutes 57 seconds East 82.32 feet; thence North 09 degrees 18 minutes 39 seconds East 61.69 feet; thence North 00 degrees 02 minutes 05 seconds West 131.89 feet; thence North 42 degrees 52 minutes 25 seconds East 108.80 feet; thence North 71 degrees 40 minutes 30 seconds East 82.12 feet to o point on the south line of the North 30.00 feet of said Southwest Quarter of the Southwest Quarter, thence South 89 degrees 53 minutes 00 seconds East 414.98 feet along said south line to the westerly right—of—woy line of Great Plains Boulevard and said line there terminating. AND EXCEPT (PARCEL 8) All that port of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota lying southerly of o line described as follows: Commencing at the southwest corner of the West 271.79 feet of the North 762.28 feet of the Southwest Quarter of the Southwest Quarter, Section 24, Township 116 North, Range 23 West, Carver County Minnesota, thence North 00 degrees 02 minutes 05 seconds West 24.26 feet on on assumed bearing along the west line of said Southwest Quarter of the Southwest Quarter to the point of beginning of the line to be described; thence North 55 degrees 30 minutes Ol seconds East 707 feet; thence North 28 degrees 09 minutes 47 seconds East 164.26 feet; thence North 44 degrees 34 minutes 08 seconds East 123.28 feet; thence North 76 degrees 30 minutes 32 seconds East 104.65 feet to the east line of the West 27L79 feet of said Southwest Quarter of the Southwest Quarter and said line there terminating. D.i" ilc Oietl,etl Br.. IWin6J5 IMI EnDMM ,Y14• 9250 GREAT PLAINS BOULAVARD ib 849 Prk Aye s. Sr DDD D.q Mena: Draw, BX kialyDb, Id W15 P"M S TbF al PARCEL SPLIT - SHEET 4 OF 4 SHEETS 51z7553D5D kV1! M.saac CHANHASSEN, MINNESOTA 812.164. M cox ic.Dpn `'``�'```f \ w IIS r I i w `r �`�` �a `�� N \ �� •: �� r ' 9 � ^c■f `r` • it i i �\ ` \ i. �/'Cwa' � / \`. p o • G ��: :I II Iil \`f `\�:: zA � r aLwl[ wmxwr I I i I. � Y I I. � i� xwxunwlE aar F a I ! I xs11 III ♦ \ Ell GONYEA 1 \ • �Eae NEMCDELMM9 .III � \ �I ePNwILI� W� III w \ f, 1� ALLIANT M I ..... I za w.ew s, 9l. ew bt `C C I MnneeVM. MN CN16 I I2lw.INxO ww i;C♦ fwIMCIM'I IL — II_ 1 �/ �i�______il iG _� . „J C _,—I�" Inow• ra� r _ C S J y o di,•r: ',� l-� �. �1.;.;. i L �i �i II it ��l � lil /i/i � n f `. A, � ab fill //L _ nr/ ` Ine"°on Lxiim� n ; • '\ ``` \ \ _L —� \ \' i+ f \ ( \ is �� 1 , �». �..... .. 6 ' r awm Yvuawyaww. ' LEGEND: LNE I — ,. PR e , u _ Pa Oa1M OlRPYAlldlx Ob _ �__ a �•, MMrmlra wlLw Ir �p .vr 9032 817E PLAN DATA �. n.o•. < wl.Nel M Rn/10 M� TIK TYPICAL LOT DETAIL .1 ro. LEGEND: •'�.w wZ r, r.�rnr�r.w�. aw v. �• pL90.NiV1 ® 5,Af1 SICIMI 5>M F GONYEA NgICISfEMOOH.IN39 ALLIANT f51 P,M Nn 8.8b9W Mlnna,pGb, MHlMI6 12'ILlt000 � 112161.9EM ,u ,nvx.YYndm.axn 7 032 •'�.w wZ r, r.�rnr�r.w�. aw v. �• pL90.NiV1 ® 5,Af1 SICIMI 5>M F GONYEA NgICISfEMOOH.IN39 ALLIANT f51 P,M Nn 8.8b9W Mlnna,pGb, MHlMI6 12'ILlt000 � 112161.9EM ,u ,nvx.YYndm.axn 7 032 Date Rece CARVER COUNTY Taxpayer Services Department Government Center - Administration Building 600 East 4th Street Chaska, MN 55318-2102 Phone (952) 361-1910 Fax (952) 361-1919 Application to Combine Real Estate Parcels Per MN Statute 272.46 the county auditor, upon written application of any person, shall for property tax purposes only, combine legal descriptions of contiguous parcels to which the applicant(s) hold title. In order to be combined, the following requirements must be met: • Receipt of completed form by owner or designated representative • Based upon deeds of record, parcels must be of the same (identical) ownership • Parcels must be contiguous • Parcels must be located in same unique taxing districts (TAG) • Current year and delinquent taxes must be paid on each parcel • If parcels are in a Tax Increment Financing District (TIF), they must be located in the same TIF district • If special assessments are not paid on all parcels, the city/township would need to recertify the special assessments for the new parcel CAUTION Parcels that have been combined cannot be subdivided again without local municipality approval. If located in a township, Carver County Land Management Office must also approve the subdivision. Combined property tax will be reflected on next year's tax statement Owner (Applicant) Name: Fo�cwooD , I-/- Address: L Address: /000 34uAE AliE N. , A'Yoo Phone Number: (o )Z — 2 O - 0692 6a,.s>&4 VAuym *% 55y2-7 Parcels to be combined: 56ZF- i` 17iktt&t� Signature: Date: For Office Use Only: Approved Denied By: Reason Denied: C.\Users\Bill1AppData\Local\Microsoft\Windows\INetCache\Content.OutlooklQD5N9R5F4Administrative subdivision Application to Combine Real Estate Parcels.doc PROVIDENCE 55 LLC 6102 OLSON MEMORIAL HIGHWAY, GOLDEN VALLEY, MN. 5542 PAY TO THE ORDER DE _ City of Chanhassen Two Hundred and 001100".,"""... " City of Chanhassen PO Box 147 Chanhassen, MN 55317 '� SEMSit 1 m _ V Z AU ORIZEO MEMO:�Ata - 11'00112811' i:09i0i7523i: 8302521 11' PROVIDENCE 55 LLC City of Chanhassen 8/2/2016 Date Type Reference Original Amt. Balance Due Discount 8/2/2016 Bill Lot Line Adj 200.00 200.00 Check Amount BRIDGEWATER BANK Bridgewater Bank 8/2/2016 J-200.00 1128 I DOLLARS 1128 Payment 200.00 200.00 200.00 PROVIDENCE 55 LLC City of Chanhassen Date Type Reference 7/11/2016 Bill Dev Review Bridgewater Bank 7/11/2016 Original Amt. Balance Due Discount 543.00 543.00 Check Amount 1119 Payment 543.00 543.00 543.00 PROVIDENCE 55 LLC City of Chanhassen Date Type Reference 7/15/2016 Bill Dev Review Bridgewater Bank 7/15/2016 Original Amt. Balance Due Discount 157.00 157.00 Check Amount 1121 Payment 157.00 157.00 157.00 COMMUNITY DEVELOPMENT DEPARTMENT CITY OF CHANHASSEN Planning Division — 7700 Market Boulevard Mailing Address — P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-1300 / Fax: (952) 227-1110 APPLICATION FOR DEVELOPMENT REVIEW Submittal Date: 6/30/2015 PC Date: 8/16/2016 CC Date: 8/22/2016 60 -Day Review Date: 8/23/2016 Section 1: Application Type (check all that apply) (Refer to the appropriate Application Checklist for required submittal information that must accompany this application) ❑ Comprehensive Plan Amendment .........................$600 ❑ Subdivision (SUB) ❑ Minor MUSA line for failing on-site sewers .....$100 ❑ Create 3 lots or less.........................................$300 ❑ Create over 3 lots ..................... $600 + $15 per lot ❑ Conditional Use Permit (CUP) ( Iots) ❑ Single -Family Residence.................................$325 ❑ Metes & Bounds (2 lots) ..................................$300 ❑ All Others .........................................................$425 ❑ Consolidate Lots .................. ............................ $150 El Interim Use Permit (IUP) E] Lot Line Adjustment.........................................$150 ❑ Final Plat ..........................................................$700 ❑ In conjunction with Single -Family Residence..$325 (Includes $450 escrow for attorney costs)' ❑ All Others ......................................................... $425 *Additional escrow may be required for other applications ❑ Rezoning (REZ) through the development contract. ❑ Planned Unit Development (PUD)...................$750 ❑ Vacation of Easements/Right-of-way (VAC)........ $300 ❑ Minor Amendment to existing PUD .................$100 (Additional recording fees may apply) ❑ All Others .........................................................$500 ❑ Variance (VAR) .................................................... $200 ❑ Sign Plan Review...................................................$150 ® Wetland Alteration Permit (WAP) ❑ Site Plan Review (SPR) ❑ Single -Family Residence...............................$150 ❑ Administrative ..................................................$100 ® All Others ................................... .................... $275 ❑ Commercial/Industrial Districts' ......................$500 Plus $10 per 1,000 square feet of building area: ❑ Zoning Appeal... ................................... .. ...... $100 ( thousand square feet) Include number of existino employees: ❑ Zoning Ordinance Amendment (ZOA) ................. $500 Include number of new employees: ❑ Residential Districts.........................................$500 NOTE: When multiple applications are processed concurrently, Plus $5 per dwelling unit ( units) the appropriate fee shall be charged for each application. ® Notification Sign (City to install and remove)....................................................................................................................... $200 ® Property Owners' List within 500' (city to generate after pre -application meeting)...................................................$3 per address (_6_ addresses) ® Escrow for Recording Documents (check all that apply)....................................................................... $50 per document ❑ Conditional Use Permit ❑ Interim Use Permit ❑ Site Plan Agreement ❑ Vacation ❑ Variance ® Wetland Alteration Permit ❑ Metes & Bounds Subdivision (2 deeds) ❑ Easements (_ easements) TOTAL FEE: $543.00 Section 2: Required Information Description of Proposal: Property Address or Location: 9150 and 9250 Great Plains Blvd, Chanhassen Parcel #: 250232100 and 250240810 Legal Description: Sections 23, 24 T1 16N, R23W Total Acreage: 42.5 Total ac: .059 proposed impact. Wetlands Present? ® Yes ❑ No Present Zoning: A2— Agricultural Estate Requested Zoning: N/A Present Land Use Designation: Residential Low -Density Requested Land Use Designation: N/A Existing Use of Property: Residential/Agricultural Section 3: Property Owner and Applicant Information APPLICANT OTHER THAN PROPERTY OWNER: In signing this application, I, as applicant, represent to have obtained authorization from the property owner to file this application. I agree to be bound by conditions of approval, subject only to the right to object at the hearings on the application or during the appeal period. If this application has not been signed by the property owner, I have attached separate documentation of full legal capacity to file the application. This application should be processed in my name and I am the party whom the City should contact regarding any matter pertaining to this application. I will keep myself informed of the deadlines for submission of material and the progress of this application. further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: PgoVtDe-,ace- ss LGC Contact: -R JI& (%OfFMi9t') Address: 6 O0 �je' / SWC Yoo Phone: 612-202-0692 City/State/Zip: Golden Valley, MN 355422- SS 427 Cell: Email: billcoff a urn .com Fax: Signature: Date: PROPERTY OWNER: In sig mg this application, I, as property owner, have full 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 to the right to object at the hearings or during the appeal periods. I will keep myself informed of the deadlines for submission of material and the progress of this application. I further understand that additional fees may be charged for consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the study. I certify that the information and exhibits submitted are true and correct. Name: Contact: Address: Phone: City/State/Zip: Cell: Email: Fax: Signature PROJECT ENGINEER (if applicable) Name: Klolhauo Environmental Services Address: 26105 Wild Rose Lane City/State/Zip: Sherwood, MN 55331 Cell: Email: ben la kiolhaugenv.com Fax: Contact: Ben Carlson Phone: 952-401-8757 Section 4: Notification Information Who should receive copies of staff reports? 'Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: ® Applicant Via: ® Email ❑ Mailed Paper Copy Address: ® Engineer Via: ® Email ❑ Mailed Paper Copy City/State/Zip: ❑ Other' Via: (-]Email ❑ Mailed Paper Copy Email: INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital copy to the city for processing (required). 15070 AMUR HILL LANE • EDEN PRAIRIE, MN 55341 MINNEAPOLIS MIN 554 12 JUL 2016 PM 9 T l IlNyw+l�j �cvt?-oPKw; �'PT. 00IN !lE CFHIWt1*•SS�^� -po fox C' 4',�ltss ) COFFMAN DEVELOPMENT SERVICES RECEIVED JUL 13 2016 CITY OF CHANHASSEN