ApplicationPlanning Case Nowt 9-' I
PLEASE PRINT
CITY OF CHANHASSEN
7700 Market Boulevard — P.O. Box 147
Chanhassen, MN 55317 — (952) 227 -1100
DEVELOPMENT REVIEW APPLICATION
CITY OF CHANHASM ++
RECF_IVEG
N0V O U 2012
gH01HASSEN PLANNING DEFT
Applicant Name and Address:
I-A-Kz. 15usAry Rtl-LS
G44A N A.A sS F >N
Contact:
Phone: 552.433a$3 0 5' Fax:
Email: JA-.. MfLAKL ;-> oFIQ to -dS6"
Property Owner Name and Address:
K n - rR'IZ iy STODA
Mo W 6�RD 5T
�& ip _sioa A MU Ls S33 1
Contact:
Phone: 9 52 41 [ Fax:
Email:
NOTE Consultation with City staff is required prior to submittal, including review of development
plans
Comprehensive Plan Amendment
Conditional Use Permit (CUP)
Interim Use Permit (IUP)
Non - conforming Use Permit
Planned Unit Development*
Rezoning
Sign Permits
Sign Plan Review
Site Plan Revie
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 remove)
X Escrow for Filing F s /Attorney Cost **
- $ UP /SPWMA AR/WAP /Metes & Bounds'
- 450 inor SUB ✓
l ft ` i I ` I S
TOTAL FEE $
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 %" 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.
NOTE: When multiple applications are processed, the appropriate fee shall be charged for
each application.
PROJECT NAME: � ADD ` < < V�
LOCATION: �3 o N rT F
LEGAL DESCRIPTION AND PID:
PTV 0")-S (b o15 10
TOTAL ACREAGE: f I
WETLANDS PRESENT: �C_ YES NO C UV '�s o�- 5 L07
PRESENT ZONING: �Z `J IF
REQUESTED ZONING: NZ t"
PRESENT LAND USE DESIGNATION: 2 S
REQUESTED LAND USE DESIGNATION: '� / CH-Arp G L
REASON FOR REQUEST: �U l� IV 1�� 7 e- r 7 0 C: 1 t'kotl 1Z
FOR SITE PLAN REVIEW: Include number of existing employees: N -A and new employees: m
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. /P l
( C-
/0 •- is - 12-
Date
j0 1a—,
Date
gAplanWormAdevelopment review application.doc