Development Review ApplicationCOMMUNITY DEVELOPMENT DEPARTMENT
Planning Division -7700 Market Boulevard CITY On CHkNHASSNMailingAddress-P.O. Box 147, Chanhassen, MN 55317it rL
Phone: (952) 227-1300/Fax: (952) 227-1110
APPLICAT IONSFOR DEVELOPMENT REVIEW
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Submittal Date: Q 13 I11 PC Date: i i cj CC Date: let=lat- I g 60-Day Review Date: i<f
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
Create over 3 lots 600 +$15 per lot
Conditional Use Permit(CUP) lots)
Single-Family Residence 325 Metes & Bounds (2 lots) 300
All Others 425 Consolidate Lots 150
El Use Permit (IUP)
Lot Line Adjustment 150
Final Plat 700
In conjunction with Single-Family Residence..$325
Includes $450 escrow for attorney costs)*CI All All Others Additional escrow may be required for other applications
through the development contract.
Rezoning (REZ)
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 All Others 275
Commercial/Industrial Districts* 500
Plus $10 per 1,000 square feet of building area: ID Zoning Appeal 100
thousand square feet)
Include number of existing employees:
CI Zoning Ordinance Amendment (ZOA) 500
Include number of new employees:
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.
Er Notification Sign (City to install and remove) 200
Property Owners' List within 500' (City to generate after pre-application meeting) 3 per address
Cs- addresses)
Er Escrow for Recording Documents (check all that apply) 50 per document
Conditional Use Permit Interim Use Permit Site Plan Agreement
Vacation 12-Variance Wetland Alteration Permit
Metes & Bounds Subdivision (3 docs.)Easements ( easements) Deeds
TOTAL FEE:
Section 2: Required Information
Description of Proposal:
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Property Address or Location: 3 N o`'ci I-1;11 cJe C.'Q'n kt 55Gi''
Parcel#: Z5". 160 1130 Legal Description: l- s .,( - " -A n- _ .3 I ' . A
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Total Acreage:Wetlands Present? Yes R'No f c5-1-0 evil ?a*0
Present Zoning: Select One Requested Zoning: Select One
Present Land Use Designation: Select One Requested Land Use Designation: SeleQJ F CHANHASSEN
Existing Use of Property: r'ZQ-s ,d et1+14..1 RECEIVED
Check box if separate narrative is attached. SEP 1 3 2019
SCANNED
CHANHASSEN PLANNING DEPT
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: Contact:
Address: Phone:
City/State/Zip: Cell:
Email: Fax:
Signature:Date:
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: ore n ' gait Contact: jam(..-
Address: 3.3z kr-,,td 1/.// vi Phone: 9 ,Z - 9f /- cp /...P
City/State/Zip: e..1)6 7 A ass n 712/ 7 3/7 sell: 6/.4 - 9140 -404.2
Email:nh`f t ems,f th 1;i k. is t Fax: it7,0
Signature: L. Date:
Pr-
This
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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:
City/State/Zip: Cell:
Email: Fax:
Section 4: Notification Information
Who should receive copies o staff reports? Other Contact Information:
Property Owner Via: Email E Mailed Paper Copy Name:
Applicant Via: Email E 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 digitallcopytothecityforprocessing. SAVE FORM PRINT FORM I SUBMIT FORM)