Application 6440 Hazeltine BlvdCOMMUNIry DEVELOPMENT DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 / Fax: (952) 227-1110
Submittal Date
*cnYotcumurssrtt
APPLICATION FOR DEVELOPMENT REVIEW
PC Date CC Date 60-Day Review Date
Section 1: Application Type (check all that apply)
Eco
nco
tr
(Refet to the appropiate Application Checklist tor required submittal infonnatbn that must ac.ompany this application)
mprehensive Plan Amendment......................... $700 E Subdivision (SUB)
n Plat 3 lots or less ...........
nditional Use Permit (CUP) n plat over 3 tots..................................
Single-Family Residence................................ $400 [ Metes&Bounds(2tots)...................
All Others............ ................ $600 11 Consolidate 1o1s...............................
. $500
$ 1250
. $300
. $150
. $150
$700-E lnterim Use Permit (lUP)
E ln conjunction with Single-Family Residence.. $400
E All Others...... .. .. . . . ....... $600
El Rezoning (REz)
n Planned Unit Development (PUD) .................. $750
E Minor Amendment to existing PUD................. $1 00
E Att others...... . .. . ............ $600
! Si9nP|anReview............................. .. .............$150
n Site Ptan Review (SPR)
! Administrative . .. . ............ $100
E Residential/Commercial/lndustrial Districts.. $750*
n Administrative Subd. (Line Adjustment)
E Final Plat.. . . .. .
Vacation of Easements/Right-of-way (VAC)
(Additional recording fees may apply)
Variance (VAR)..................
Wetland Alteration Permit (WAP)
n Single-Family Residence.......................n ntt otners......
Appeal of Administralive Decision
Zoning Ordinance Amendment (ZOA).........
tr
tr
tr
tr
u
$300
$200
$150
$275
$200
$500
lgIE: When muttipte applications arc processed concunently, the amrcpriate fee shall be charged for each aPpllcation.
fl Escrow for Recording Documents (check all that apply).............. . .. . ..... .. ...... .. . $ per document
E Conditional Use Permit - $50 E lnterim Use Permit - $50 E Site Plan Agreement - $85
n Wetland Alteration Permit - $50 E Easements (- easements) - $85 E Vacation - $85
E Variance - $50 E Metes & Bounds Sub (2 deeds) -$250 E Deeds-$100
TOTAL FEE:
"lncludes $450 escrow for attorney costs.
""Additional escrow may be required for other applications through the development contract.
Itdo -
Section 2: Required lnformation
Description of Proposal
Property Address or Location
Parcet #.25.0940020 lot 2 block 1 , Beehive Homes 2nd additionLegal Description
Total Acreage:
Present Zoning
5.51 Wetlands Present?
Medium Density Residential
E ves E tlo
Requested Zon ing High Density Residential
Present Land Use Designation R-8 (medium density)Requested Land Use Designation R-16 (high density)
Existing Use of Property
E Check box if separate narrative is attached
6440 Hazeltine Blvd
vacant land
Section 3: Property Owner and Applicant lnformation
APPLICANT OTHER THAN PROPERTY OWNER: ln signing this application, l, 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. lf this application has not been signed by
the property owner, I have attached separate documentation of full legal capacity to flle 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. lwill keep myself informed of the deadlines forsubmission of matenal 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
Address
Contact
Phone:
City/State/Zip
Email:
Cell:
Faxl
DateSignature
PROPERTY OWNER: ln signing this application, l, 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 submlssion of material and the progress of this application. I further understand that additaonal 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 exhrbits submitted are true and correct.
t"r", Tyler Stevens Contact:
Address: PO Box 606 Phone. 612.770.7611
City/State/Zip Excelsior, MN 55331
an.,r,,. Tyler@ivory-.com
Signature
PROJECT ENGINEER (if applicable)
Name:
Cell:
Fax:
Date Z/, ?L
Address
Contact
Phone:
City/State/Zip
Email:
Cell
Fax
This application must be completed in full and be typewritten or clearly printed 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.
A determination of completeness of the application shall be made with in 15 business days of application submittal. A
written notice of application deficiencies shall be mailed to the applicant within 15 business days of application.
Who should receive copies of staff reports?
owner Emait tyler@ ivory-bell.com Name
'Other Contact lnformation:
I Property
E Applicant
! EngineerE otner
Address
City/State/Zip
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.
Email
Email
Email
Section 4: Notification lnformation