Development Review ApplicationSore^o1
COiliiUNITY DEVELOPiIENT DEPARTTENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1300 / Fax: (952) 227-1'l1o
APPLICATION FOR DEVELOPMENT REVIEW
suumitatDate: ? Ia / fA PC Date
q 3 I ccoate:Q /an lrq SGDay Review Date:to( tI Lc
Section 1: Application Type (check all that apply)
(Refer to tp apprcpiate Applitxtin c/?f,cldistr tor ,pqui.E,d submiftal infomat*m tl!€,l musl a@npany this applbatim)
n Comprehensive Plan Amendment......................... $600 ! SuMivision 1suB1E Minor MUSA line br f;ailing on-site sewers.....$100 E Create 3 lots or less ........................................ $300E create over 3 lotsD Conditional Use Permat (CUP)
! Single-Family Residence ...
E rut ottrers......
E
p ntt otners......
E nezoning 1nez1E Planned Unit Oevelopment (PUO)....
n Minor Amendment to existing PUD...
E A others......
E Sign Plan Review..........
E site Plan Review (SPR)
E Administrative.........
lnterim Use Permit (lUP)
fl ln conjunction with Single-Family Residence.. $325
.....................$600 + 915 per tot(__ lots)E Uetes & Bounds (2 lots).
E Consolidate Lots..... ... ... ..
E Lot Line Adjust nent........
E Final Plat.........................
(lncludes $450 escrow for attomey cosb)'
'Additbnal es$ow may be ,equired ior other applications
through the development contrad.
E Vacation of Easements/Right-of-way (vAC)........ $300
(Additional recording fees may apply)
.. $325
..$425
$425
$7s0
$100
$s00
$1s0
.... $100
....9500
$300
$1s0
$1s0
$700
tr
tr
E Commerciaulndustrial Districts'
Plus $'10 per 1,000 square feet of building area( thousand square feet)
'lnclude number of g!!s!Dg enployees:
Variance (VAR) ...... .
Wetland Alteration Permit (WAP)
E Singl+.Family Residence........
.. $200
E Att ohers.........
D zoning Appeal........
E Zoning ordinance Amendment (ZOA)........-........ $500
$200
. $150
.$27s
$100
'lnclude number of @!t employees:
tr nesioentiar oiiiti"t"-.....--f -.-.......---..--- Ssoo !QIE*: when rnuhirlc 'Pplio'tior rrt Foo'ss'd concurrundv'
Plus $5 per dwelling unit r uni;i th' 'PPropritt'
lbc sh'll b' oh"god ior .toh rPPllottion'
K
*
d"
Notification Sign (city to install and remove)
Property Owners' List within 500' (city to generate after pre-application meeting) .....
Escrow for Recording Oocuments (check all that
E Conditional Use Permit
app
D
lv)...........................
lnterim Use Permit
E Vacation E variance
n Metes & Bounds Subdivision (3 docs.) E Easements ( easements)
.... .. ...$3 per address
t lSaddresses)
....... $50 per document
E site Ptan Agreernent
Alteration
,ko
E weuanoE oeeos
TOTAL FEE
Permit
Section 2: Required lnformation
Description of Proposal: Mootl \)all -t truP L(\on*;on
flz:r,,e cloJ Drit-loo + 2o0Property Address or Location
Parcel #:Legal Description:Lol
Weuands PresenP ! Ves E tto
3 .49
Total Acreage:
Present Zoning
Present Land Use Designation:
Requested Zoning . Select One
Requested Land Use Designation:Select ne E
ffnecX box if separate nanative is attached
AUb 0z z0lg
SCfNNEt)
Select One
One
Existing Use of Property:
et
Section 3: Property Owner and Applicant lnformation
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 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 perteining to this
application. I ' rill keep myself informed of the deadlines for submission of material and the progress of this applic€tion. I
further understand that additional fees may be charged ior 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 conect.
Name:Contect:
Phone:Address:
City/State/Zip
Email:
study.
Name
Address:ill
City/State/Zip:
Email <.
Signature
PROJECT ENGINEER (if appl icable
Name:
Address
?orla
(/f / aaaual
conect.
"azti,:,,
o Cell
, ar\.r.- Fax:
Cell:
Fax:
Date
Davt Z ie,t'5
phone: 6ra 'f'zo-5154
Datei 7-3o- 11
Signature
I certity that the information and exhibits submitted are true and
)
Contact:
Phone:o0
i lvl tlt {szq I
sa{1"te..Conn
This application must be completed in full and must be accompanied by all information and plans required by
applicable City Ordinance provisions. Bebre filing this application, rerer to the appropriate Application Checklist
and conEr with the Planning Department to determine the specific ordinance and applicable procedural
requirements and Ees.
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.
Section 4: Notification lnformation
Who should roccive copi6s ot staft r.ports?
trn Property Owner Via: ! EmailApplicant Via: D Emailn Engineer Ma: E EmailE omer Via: E Emait
E ttiitaiteo Paper copy
E ttrtaileo Paper copy
E tvtaiteo Paper copy
E uaneo Paper copy
Address
INSTRUCTIONS TO APPLICANT: Com plete all necessery form fields, then select SAVE FORM to save a copy to your
device. PRINT FORM and deliver to city along with required documents and payrnent. SUBMIT FORM b send a digital
copy to the city for processing
SAVE FORTI PRINT FORM SUB N FORM
PROPERW OWNER: ln signing this application, l, as property owner, have tull 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 turther understand that additional fiees may
be charged br consulting fees, feasibility studies, etc. with an estimate prior to any authorization to proceed with the
+
city/state/zip:
Email:
Cell:
Fax:
'Othor Contact lntomation:
No-o
ciMstate/zip:
Email: