Development Review Application€tPt1- to
COMMUNITY DEVELOPMENT DEPARTUENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box '147, Chanhassen, MN 55317
Phone: (952) 227-'1300 / Fax: (952) 227 -1110
Submitlal Date
! Comprehensive Plan Amendment......................... $600E Minor MUSA line for failing on-site serryers..... $1OO
n Conditional Use Permit (CUP)
! Single-Family Residence! att ottrers.......
! lnterim Use Permit (lUP)
E ln conjunction with Single.Family Residence.. $325! All orhers $425
n Rezoning (REz)
trn Planned Unit Development (PUO)
Minor Amendment lo existing PUD
................. $750
................. $100
................. $sm
CITY OT CHAI{IIASSII'I
APPLICATION FOR DEVELOPMENT REVIEWI2-6)no".113l tq ccoateQ(g-[g- sooay Revisv Dare: lo I , ltz
(Refer lo tlr€ app,Wdate Applbdi,. ClFcklist lot Gquicd submittal inlol|rltr,ti}]. ths, mun ac@mpany this e4iptb5/.ixl)
E SuMivision (SUB)
E Create 3 lots or lessE Create over 3 |ots.......................$600 + $15 per lot(_ tots)! Metes & Bounds (2 lots).................................. $300tr!Consolidate Lots.
Lot Line Adiustment
E Final Plat
............ $300
.. ..........$1s0
$32s
$42
$150
$100
ss00
..........................'..... s700
$1s0
E nn oners.......
E Sign Plan Review.......................
E Site Plan Review (SPR)
tr!Administrative
(lncludes $450 escro , br attorney costs)'
'Add,tjo.El escrow may be equiEd fu. ofrrer applicatioos
thmqh the de\leloflnent contsct.
E Vacation of Easements/Rirht-of-u,ay (VAC)........ $300
(Additionel tEcodnE E€8 m8y +ply)
fr v"n nu (vAR)...........................
fl Wahnd Alteraion Permit (wAP)!tr
E Residential Dislricts $500
Plus $5 per dwelling unit ( units)
F Notificetion SilJn (city ro irEts 8nd remoie)
El property Owne6' List within 5@' (city to gs{Eratr ster Fs€ppricrtoo m€cfrlg) ....
Commercial/lndustrial Districls'
Plus $10 per 1,000 square fuet of building ersa:( thousand squar€ fed)
'lnclude nl'mber of llllslhg emdoysG:
'lrrclude number of @ employeB:
apptratr
SingleFamily Residence .......... t150
.......... $27sAll Others......
I Zoning Appea|..........$100
! Zoning Ordinance Amendment (ZOA)................. $500
Ill)IE: Wion multlple appllcltions .ro proce6sed concurendy,
fhs tPproprlrta to€ Ehrll bo chargod ior each lppllcrtlon.
s200
$3 per address( <3' addresses)
S fgcrow for Recording Documents (check all thet(-l$t Conditional Use Fermit- Ll Vacation
E Maes & Bounds SuMMsion (3 docs.)
lv).........................
lntorim Use Permit
Variance
Easements (_ easements)
....................... $50 per document
E Site Plan AgreementE Wetland Alteration Permitl-l oeeos lr, o
i6t11- resr )',1 , o0
Section 1: Application Type (check all that apply)
Section 2: Required lnformation
Description of Poposal Ro wr0ue c--,., J '-'rgt-"a ap'i4 tnJ 7a.e45e
a* o-J.1, {.^ .'- boy,(-5 vn..)\4- .,so*\J toe b,-,'lt o ue.,'9 o-. ..- I e.
Property Address or Location
Parcel #:
Select One
Legal Description:L o-\ 'z a q.k
Wetlands Present? E Yes E No
G o53
PI
ed*h
Total Acreage:
Present Zoning
Present Land Use Desig nr1;on. Select One
Requested Zoning Select One
Requested Land Use Desig 6s1ion. Select One
Existing Use of Property:Vq9. d ew,-L t
$200
lcheck box if separate nanative is attacfied.
Section 3: Property Owner and Applicant lnformation
AppLlcANT OTHER THAN PROPERTY OWNER: ln signing this application, l, as applicant, represent to have obtained
authorization from the property owner to file thb 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. It this applicatioi has not been signed by
the pioperty owner, I have attaahed separate documenlation of full legal capacity to file the aPplication. This application
should be frocessed in my name and I am the party whom the City should contact regarding any matter pertaining to this
application. I will keep mysetf informed of the deadlines for submission of material and the progress of lhis application. I
furiher understand th;t additional fees may be charged for consulting fees, feaslbality studies, etc. with an estimate prior to
any aulhorization to proceed with the study, I certify that lhe information and exhibits submitted are true and corecl.
Address:
Name:Contacl
Phone:
Cell:
Fax:
Date
Contact:
Phone 6lz _ztL-gL-?9
9 6- vwr L
city/state/zip
PROPERTY OWNER: ln signing this applbation, 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, subjecl only to the right to objec{ at the hearings or during the appeal periods. I will keep myself informed of
the deadlines f;r submission of materbl and the progress of this application. I further understand that additional fees may
be charged for consulting fees, feasibility studie8, etc. with an estimate prior to any authorization to proceed with the
study. I certify thal the information and exhibits submitted are true and conect.
Signature
city/state/zip
Email
Name:
C \. a-w
Name: f o- -" e 1
Address: G 4
l-rvt
Ltc. Par k".-'-
br,t Cell:
Fax:
Cell:
Fax:
o
Signature
PROJECT ENGINEER (if applicable)
Date: )'
Address:
Contact
Phone:
City/State/Zip
Email:
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.
u iredandionmbealnformalandust byfullbemustreqplanstsThaccompaniedbypliap
hecklistctheicationBeforethisleOrdncenaappropriateApplapplicationprouslons.filingityapplicab
dn icable roced raUrdioanancethendeterminetoaPplpDepartmentspecificn rn9and confer with the Pla
requirements and fees.
Who should receive copi6 of staff rePorB?
ntr!tr
Property Owner Ma: E EmailApplicant Ma: ! EmailEngineer Ma: E EmailOthef Ma: E Email
E Mailed Paper Copy
! Mailed Paper copy
E Mailed Paper Copy
! Mailed Paper Copy
City/Statezip:
INSTR UCTIONS TO APPLIGANT:Complete all necessary form fields, then selec{ SAVE FORM to save a coPy to your
device. PRINT FORM and deliver to city along with requiled documents and payment. SUBMIT FORM to send a digital
copy to the city for processing
SAVE FORiI PRINT FORITI SUA IT FOR
Email:
refer to
Section4: Notificationlnformation
'Other Contact lnfomatlon:
Name:
-
Address:
Email: