ApplicationPLEASE PRINT
CITY OF CHANHASSEN
7700 Market Boulevard — P.O. Box 147
Chanhassen, MN 55317 — (952) 227 -1100
DEVELOPMENT REVIEW APPLICATION
r'I`CY OF CHANHASSEN
MAR 2 1 2011
0HANHASSEN PLAUNING DEPT
Applicant Name and Address: Property Ova
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Contact: Lc, u t, Contact:
Phone: 6 /- 3 3 - 4qG , - Fax: 2 Z - ° - Za - 7 Phone: /-
Email: /<h gj;g Jog a,,` , Email: _
Planning Case No.�^
Fax: �iS2- o�7 - Zc� 7
NOTE Consultation with City staff is required prior to submittal, including review of development
plans
Comprehensive Plan Amendment
_ Conditional Use Permit (CUP t�a�
Interim Use Permit (IUP)
Non - conforming Use Permit
Planned Unit Development'
Rezoning
Sign Permits
Sign Plan Review
X Site Plan Review (SPR)* D
Subdivision*
Temporary Sales Permit
Vacation of Right -of- Way /Easements (VAC)
(Additional recording fees may apply)
Variance (VAR)
Wetland Alteration Permit (WAP)
Zoning Appeal
Zoning Ordinance Amendment
Notification Sign $200
(City to install and ve)
X Escro F Fees /Attorney Cost"
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-$5 CNAR/WAP /Metes & Bounds
- $450 Minor SUB P cl 312-1 If
TOTAL FEE $ 2 - 7 q- /&,,. c l6J& i s d
An additional fee of $3.00 per address within the public hearing notification area will be invoiced to the applicant
prior to the public hearing.
*Five (5) full -size folded copies of the plans must be submitted, including an 8' /z" X 11" reduced
copy for each plan sheet along with a digital copy in TIFF -Group 4 ( *.tif) format.
"Escrow will be required for other applications through the development contract.
Building material samples must be submitted with site plan reviews.
Name and Address:
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NOTE: When multiple applications are processed, the appropriate fee shall be charged for
each application.
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PROJECT NAME:
LOCATION: - 7g 0 5 4V': a 4haM /-7P —b �
LEGAL DESCRIPTION AND PID:
TOTAL ACREAGE: /- / '�, 14
WETLANDS PRESENT: YES NO
PRESENT ZONING: 14
REQUESTED ZONING: I3 4
PRESENT LAND USE DESIGNATION:
REQUESTED LAND USE DESIGNATION:
REASON FOR REQUEST:
FOR SITE PLAN REVIEW: Include number of existing employees: and new employees: a
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, you should confer with the
Planning Department to determine the specific ordinance and procedural requirements applicable to your application.
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.
This is to certify that I am making application for the described action by the City and that I am responsible for complying with
all City requirements with regard to this request. 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 have attached a copy of proof of ownership
(either copy of Owner's Duplicate Certificate of Title, Abstract of Title or purchase agreement), or I am the authorized person
to make this application and the fee owner has also signed 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. The documents and information I have submitted are true and correct to the best of
my knowledge.
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Sig t re o Applicant Date
F L�� T
Signature of Fee Owner
- 21-11
Date
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gAplaMformAdevelopment review application.doc