Development Review ApplicationRECEIVED
JAN 0 4 2019
CTIANIIASSEN PLAI,II{II{G DEPT
COMMUNITY DEVELOPMENT DEPARTM ENT
Planning Division -7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1300 / Fax: (952) 227-1110 *cTTYoICnAl{na$sril
APPLIGATION FOR DEVELOPMENT REVIEW
Submittaror,"t\q\rq eco"t",A[Sltl ccDate:al:Sltq 60-DayReviewor", 3/ Slr?
Section 1:all that
(Refer to the appropiate Application CheckJist for requircd submittal information that must accompany this application)
tr Comprehensive Plan Amendment. ... $600
E Minor MUSA line for failing on-site sewers ..... $100
Conditional Use Permit (CUP)
E Single-family Residence ................................ $325
E rut otners................... .................$425
lnterim Use Permit (lUP)
! ln conjunction with Single-Family Residence.. $325E rut otners................... .................S425
Rezoning (REZ)
n Planned Unit Development (PUD) .................. $750
n Minor Amendment to existing PUD................. $100
E ntt others.......... ..... $500
Z Suooivision (SUB)' Z Create 3lots or less
E Create over 3 lots...n $600 + $15 per lot
tr
( lots)
-a t n Metes & Bounds (2lots) .............$300'sr/tz E Consolidate Lots.......... ...............$150"*Q Lot Line Adjustment... .................$150'Q Final P|at............... ......................$700
(lncludes $450 escrow for attorney costs)*
'Additional escro^, may be required for other applications
through the development contrac{.
E Vacation of Easements/Righlof-way (VAC)........ $SOO
(Additional recording fees may apply)
tr
E Variance (VAR)$200
! Sign Plan Review. ........ $150
E Site Plan Review (SPR)
E Rdministrative............. ................ $100
n Commercial/lndustrial Districts* ...................... $500
Plus $10 pel!,000 square feet of building area:( thousand square feet)
"lnclude number of extslrno employees:
*lnclude number of nCly employees:
E Residential Districts.... ................ $500
Plus $5 per dwelling unit ( units)
E Wetland Alteration Permit (WAP)
[J Singte-family Residence....fl Rtt otners............................
$1 50
$275
$100E Zoning Appeal
E Zoning Ordinance Amendment (ZOA)... ..... ....... $500
EIE: When multiple applications are processed concurrently,
the appropriate fee shall be charged for each application.
tNom"ation Sign (city to instatt and remove) ....... $200
/ eroperty Owners' List within 500' (city to generate after pre.application meetins)
&;il;;;*") qgd, 0", address
E Escrow for Recording Documents (check all that ?pply)...........n ConditionalUse Permit tr lnterim Use Permit
E Vacation ' Z Variance
fl Metes & Bounds Subdivision (3 docs.) tr Easements ( easements)
Section 2:lnformation
Description of Proposal:
Property Address or Location:
Parcel #:Legal Description:
TotalAcreage: /,Ob Wetlands Present? E Yes
Present Zoning: Select One Requested Zoning:Select One
Present Land Use Designation: Select one Requested Land Use Designation:Select One
Existing Use of Property:
EChecf box if separate narrative attached.
B/oo/c1
APPLICANT OTHER THAN PROPERTY OWNER: ln signing this application, l, 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. lf this application has not been signed by
the property owner, I have aftached 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 are true and correct.
Name:Contact:
Phone:Address:
tJo
City/State/Zip:
Email:
Signature:
PROPERTY OWNER: ln signing this application, l, 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.fr
cer: S,Aa,a €
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contact: 13.YV C o
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Phone: q92'+-l+ '5rt5 t
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Signature:
PROJECT-
Name:
Address:
Who should receive copies of staff reports?
Property Owner Via:Applicant Via:Engineer Via:Other* Via:
E rrllaiteO Paper Copy
E vtaiteo Paper copy
! trlalteo Paper Copy
E tritaiteO Paper Copy
Cell:
Fax.,
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.
conract: D(1)rufu'
Phone:
*Other Contact lnformation:
Name:E Email
E Emalt
E Emait
E Emait
trnntr
Address:
City/StateZip:
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.
Section 3:Owner and lnformation
Date:
Name:
Address:
City/StateZip:
Section 4: Notification lnformation