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ApplicationSG li �)-6 ( (0 ©,;I, COMMUNITY DEVELOPMENT DEPARTMENT Planning Division -7700 Market Boulevard CITY OF CHANIIASSEN Mailing Address — P.O. Box 147, Chanhassen, MN 55317 Phone: (952) 227-13001 Fax: (952) 227-1110 APPLICATION FOR DEVELOPMENT REVIEW Submittal Date: PC Date: I — c I (a CC Date: r 5-- % fP 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 ❑� Conditional Use Permit L1 Create over 3 lots.. + $15 per lot (CUP) lots) (—ots) ❑ Single -Family Residence ................................ $325 ❑ Metes & Bounds (2 lots) ........ .......................... $300 0 All Others .........................................................$425 ❑ Consolidate Lots .............................................. $150 F-1 Interim Use Permit (IUP) EJ Lot Line Adjustment.........................................$150 ElFinal Plat E] 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 El All Others ................................................. ...... $275 ❑ Commercial/Industrial Districts*......................$500 ❑ Zoning Appeal Plus $10 per 1,000 square feet of building area: ...................................................... $100 ( thousand square feet) *Include ❑Zoning Ordinance Amendment (ZOA)................. $500 number of existing employees: Include number of new employees: Fl 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) .......... ... ........................ ! - LK... $3 per address ( addresses) 4,51 Escrow for Recording Documents (check all that apply) ......................................... . $50 per document Conditional Use Permit El Interim Use Permit ❑ Site Plan Agreement Vacation ❑ Variance ❑ Wetland Alteration Permit ❑ Metes & Bounds Subdivision (3 docs.) ❑ Easements( easements) ,y TOTAL FEE: � Z9-,(, � Section 2: Required Information Description of Proposal: Currently office space and warehouse. Want to start using it as an adult day care center. Property Address or Location: Parcel #: 18-116-22220010 Legal Description: 18976 Lake Drive East Chanhassen, MN 55317 Lot 001 BILK 001 Addition: Chanhassen East Business Center Total Acreage: Wetlands Present? ❑ Yes ® No Present Zoning: Industrial Office Park District (IOP) Requested Zoning: Industrial Office Park District (IOP) Present Land Use Designation: Office/Industrial Requested Land Use Designation: Office/Industrial 0 Existing Use of Property: Office space and warehouse ❑ Check box is separate narrative is attached. 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. 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: Mount Olivet Rolling Acres Contact: Bruce I orgerson Address: City/State/Zip: 18986 Lake Drive East Chanhassen MN 55317 Phone: Cell: (952)401-4847 Email: BruceT@mtolivetrollingacres.org Fax: (952) 474-3652 Signature: I G Date: 12/2/15 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: CSM Corporation Contact: Kelly J. Ramstad Address: 500 Washington Av. S. Ste 3000 Phone: (612) 395-7094 City/State/Zip: Minneapolis MN 55415 Cell: (612) 366-0758 Email: kramstad@csmcorp.net Fax: (612) 395-2755 Signature: Date: 12/2/15 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) 1►FTiS=A Address: Contact: 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: 0 Applicant Via: Email Z 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 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. 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: Mount Olivet Rolling Acres Contact: Bruce Torgerson Address: 18986 bake Drive East Phone: (952) 401-4847 City/State/Zip: Chanhassen MN 55317 Cell: Email: BruceT@mtolivetrollingacres.org Fax: (952) 474-3652 Signature: —' pate: 1212115 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: CSM Corporation Contact: Kelly J. Ramstad Address: 500 Washington Av. S. Ste 3000 Phone: (612) 395-7094 City/State/Zip: Minneapolis MN 55415 Cell: (612) 366-0758 Email: ramstad@csmcorp.net Fax: (612) 395-2755 Signature: Date: 1212/15 This application rfiust 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: Address: City/State/Zip: Email: Contact: Phone: Cell: Fax: Section 4: Notification Information Who should receive copies of staff reports? *Other Contact Information: ❑ Property Owner Via: ❑ Email ❑ Mailed Paper Copy Name: a Applicant Via: ® Email Mailed Paper Copy Address: EJ 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