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Application for Development Review 17-01APPLIQ cc ?Relarfia the sivroadefe Apoftaft1tion Chackyst for Mqiari OrAprehOnSIVe Plan Amendment .........................$600 minor MUSA line for failing on-alte sewers.....$100 El Conditional Use Permit (CUP) ❑ Single -Family Residence ................................$325 ❑ All Others ...................................................... _$425 ❑ Interim Use Permit (]UP) ❑ In conjunction with Single -Family Residence.. $325 -All. Others-....................................................... $425 ❑ Rezoning (REZ) 0 Planned Unit Development (PUD) .................. $750 11 Minor Amendment to existing PLO .................$100 0 All Others ......................................................... $.500 ❑ Sign Plan Review ................................................... $,so Site Plan Review (SPR) 0 Administrative ..................................................$100 0 Commercial/Industrial Districts*......................$500 Plus $10 per 1,000 square feet of building area: ( 5,700 thousand square feet) 'Include number of axis employees: 6 'Include numberof now employees: ___X_ C1 Residential Districts .........................................$500 Plus $5 per dwelling unit ( units) D Subdivision (SUB)di El Create 3 lots or lets ............... 11 Create over 3 lots .................... $600+$15 par Toth; + lots) 11 Metes & Bounds (2 lots)............ 0 Consolidate Lots ................. ......... Q Lot Line Adjustment.,--... n Final Plat. (includes �"*��r, io­r' ......... attorney costs)- *Addiflonal escrow may be reciulred for other appi6flails through the development contract, ght-of-way (VAC ...... $ (Additional recording farm may apply) n Vacation of Easements/Ri '30 n Variance (VAR) .................................................... $200 , ❑ Weiland Alteration Permit (WAP) 0 Single -Family Residence... ........ ............... $150 0 All Others ....................................................... $27$ nZoning Appeal ...................................................... $100. 11 Zoning Ordinance Amendment (ZOA)................. $506. NOTE: When multiple applications are processed concurmatly, the appropriate fes shall be charged for each application. 21 Notification Sign (city to instau and remove) ........................................................................................................... I ........ U00, 0 Property Owners' List within 500' (city to generate sear ilre-spplication meeting) .................................................. $3 per address .0 Escrow for Recording Documents (check all that a(ID addresses) pply) ........ .............................................................. $60 per document .0 CcindWonal Use Permit Interim Use Permit Site Plan A :0 Vacation 0 Variance Weiland A Gres on Metes & Bounds Subdivision (3 docs.) 13 Easements( easements) sa TOTAL FEE: 4011 Proposal to build a 5700.square foot pediatric denial office. ocajForl 7845 Century Biyd. Ci 0a Hassan M. a7 �. r trs n wI s in eep'myself. Informed'ofthe daadlihos for submission of material and.the pti Totlttt1eP41dttd444padditi6nsl fees may be aharggd for consulting fees; feasibility studieax oto (5 f o p a w ��9 Wthoriza bn E'o proceed with the study. I certify that the Information and exhibits submlltet! ems. + e a`n�loktk , it W "RGR NOlding%: LLC RdtieitConrad Contacts %kddress: 2665 W 78th Streetti. Phone: (962)4tl1.324'i':;: City/State/Zlipr Chanhassen; MN 55317 Cell: :Email: RCo ieQ e t N .com Fax: Signature: pate; 1%411.7 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: i ,_ ,e Address: SOS 8 uv l l� STwc Phone: -(2-5 CityfState0p: A�� i�6V1 - b �J 7 0 '7 i� Cell: Email: STz,e_Fax:!01?1?3 Signature: Data:—i- 4-1- j 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: Cityl9tafiop: Cell: Fa)c - YSection 4: Notification Information &fi ett¢gld reeslVa ceptesof staff reports? "Other Contact Information: a i� iro RY la, 4Yrier. Vil ❑Email ❑ Milled Paper Copy Name y g1 p, d 6tnall [] Nulled Pipit Capy City/State a ` weer}a 3© Email a Ma(ied Piper Cop Address »4 :....e:�©Eiiialt © Milled PanerConv t;rsaa w? - t