ApplicationCi %J I V i )
57
COMMUNITY DEVELOPMENT DEPARTMENT ~V�
Planning Division —7700 Market Boulevard OCT 16 20 CITY OF C11I]1111171JAJLl1
Mailing Address — P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1300 /Fax: (952) 227-1110
APPLICATION FOR DEVELOPMENT REVIEW
Submittal Date: 10 — I (a — I ii PC Date: I 1 —1—t — )'-=i CC Date: QL —14-1 S 60 -Day Review Date: 11. — Is — I S_
Section. • . (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
21 Sign Plan Review ................................................... $150
Q Site Plan Review (SPR)
❑ Administrative.................................................. $100
❑v Commercial/Industrial Districts*......................$500
Plus $10 per 1,000 square feet of building area:
4( ,000 thousand square feet)
*Include number of existing employees: 11
*Include number of new employees: 3
❑ Residential Districts ......................................... $500
Plus $5 per dwelling unit (_ units)
❑ Subdivision (SUB)
NOTE: When multiple applications are processed concurrently,
the appropriate fee shall be charged for each application.
❑✓ Notification Sign (city to install and remove)...................................................................................................................... $200
❑r Property Owners' List within 500' (City to generate after pre -application meeting) .................................................. $3 per address
( 28 addresses)
❑ Escrow for Recording Documents (check all that apply) .............................................
❑ Conditional Use Permit ❑ Interim Use Permit
❑ Vacation ❑ Variance
❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements (_ easements)
'j�kr &d 1 _ sCIWJ d Pd c K44 -7�� (e
...................... $50 per document
❑r Site Plan Agreement
❑ Wetland Alteration Permit
TOTAL FEE: $1,024.00
Description of Proposal: Construction of an approximately 4300sgft medical building, with additional lot area remaining
for a future additional building.
Property Address or Location:
195 W. 79th Street
Parcel #: 253010020 Legal Description: Lot 2, Block 1, Gateway East 2nd Addition, Carver County, Minnesot
Total Acreage: 1.29 Wetlands Present? ❑ Yes ® No
Present Zoning: Highway and Business Services District Requested Zoning: Highway and Business Services District (E
Present Land Use Designation: Commercial
Existing Use of Property: Vacant
❑ Check box is separate narrative is attached.
Requested Land Use Designation: Commercial
❑ Create 3 lots or less ........................................
$300
❑ Create over 3 lots .......................$600 + $15 per lot
(_ lots)
❑Metes & Bounds (2 lots)..................................$300
El 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.
❑✓ Notification Sign (city to install and remove)...................................................................................................................... $200
❑r Property Owners' List within 500' (City to generate after pre -application meeting) .................................................. $3 per address
( 28 addresses)
❑ Escrow for Recording Documents (check all that apply) .............................................
❑ Conditional Use Permit ❑ Interim Use Permit
❑ Vacation ❑ Variance
❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements (_ easements)
'j�kr &d 1 _ sCIWJ d Pd c K44 -7�� (e
...................... $50 per document
❑r Site Plan Agreement
❑ Wetland Alteration Permit
TOTAL FEE: $1,024.00
Description of Proposal: Construction of an approximately 4300sgft medical building, with additional lot area remaining
for a future additional building.
Property Address or Location:
195 W. 79th Street
Parcel #: 253010020 Legal Description: Lot 2, Block 1, Gateway East 2nd Addition, Carver County, Minnesot
Total Acreage: 1.29 Wetlands Present? ❑ Yes ® No
Present Zoning: Highway and Business Services District Requested Zoning: Highway and Business Services District (E
Present Land Use Designation: Commercial
Existing Use of Property: Vacant
❑ Check box is separate narrative is attached.
Requested Land Use Designation: Commercial
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.
Name: RBSC Chanhassen, LLC Contact: Randall Schold
Address: 8925 Twin Lakes Crossing Phone: (651) 523-1244
City/State/Zip: Eden Prairie, MN 55347 Cell: (612) 991-6243
Email: rschold@metroplains.com Fax: (651)523-1255
Signature: Randall J Schold Date: 10/16/15
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: Contact:
Address: Phone:
City/State/Zip: Cell:
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)
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