Development Review ApplicationCOMMUNITY DEVELOPMENT DEPARTMENT
Planning Division —7700 Market Boulevard
Mailing Address—P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1300/ Fax: (952) 227-1110
APPLICATION FOR DEVELOPMENT REVIEW
Submittal Date I ( ( aL PC Date 4 I a DG' CC Date Id I /4C)60-Day Review Date L /3c,./
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
Conditional Use Permit (CUP)
Create over 3 lots (
lots) $
600 +15 per lot
Single-Family Residence 325 Metes & Bounds (2 lots) 300
All Others 425 Consolidate Lots 150
71Interim Use Permit (IUP)
r] Lot Line Adjustment 150
In conjunction with Single-Family Residence..$325
17) Final Plat 700
All Others 425 Includes $450 escrow for attorney costs)*
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
Q Variance (VAR). 200
Sign Plan Review 150
Wetland Alteration Permit (WAP)
Site Plan Review (SPR) LI Single-Family Residence 150
Administrative 100 All Others 275
Commercial/industrial Districts' 500
Plus $10 per 1,000 square feet of building area: Zoning Appeal 100
thousand square feet)
Include number of ex: gemployees Zoning Ordinance Amendment (ZOA) 500
Include number of new employees
Residential Districts 500 ligJ : When ngdtlpleapplications are processed concurrently,
Plus $5 per dwelling unit (units)
the appeoprlaletire*d be charged for each application.
Q Notification Sign (City to install and remove) 200
Q Property Owners'List within 500' (City to generate after pre-apphcation meeting)3 per address
11 addresses)
Escrow for Recording Documents (check all that apply)50 per document
Conditional Use Permit Interim Use Permit Site Plan Agreement
El Vacation Variance Wetland Alteration Permit
Metes & Bounds Subdivision (3 docs.)Easements ( easements) Deeds
TOTAL FEE: SSD I
Section 2: Required Information
Description of Proposal:
Property Address or Location: 565 LAKOTA LANE
251300010 BLUFFVIEW ADDITION LOT 001Parcel#:Legal Description:
Total Acreage:
2 57
Wetlands Present? Yes ® No
Present Zoning: Agricultural Estate District (A2) Requested Zoning: Agricultural Estate District (A2)
Present Land Use Designation: Residential Low Der Requested Land Use Designation: Residential Low Densi
Existing Use of Property: SINGLE FAMILY RESIDENCE
Check box if separate narrative is attached.
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:
FRANCISCO SILVA Contact:
FRANCISCO SILVA
Address:
565 LAKOTA LN Phone:
952-484-9366
City/State/Zip:
CHASKA, MN, 55318 Cell:
Email:
C CO.SILVA3@GMAIL.COM Fax:
Signature: Date: 04/20/2020
This application must co .le 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 of staff reports? Other Contact Information:
0 Property Owner Via: 0 Email 0 Mailed Paper Copy Name:
HEATHER SILVA
Applicant Via: Email Mailed Paper Copy Address: 565 LAKOTA LANE
Engineer Via: Email Mailed Paper Copy City/State/Zip:CHASKA, MN,55318
0 Other* Via: 0 Email Mailed Paper Copy Email: HEATHER.LYNN SILVA@GMAILCOM
INSTRUCTIONS TO APPLICANT: Complete all necessary form fields,then select ,ti .to save a copy to your
device. and deliver to city along with required documents and payment. SUE. to send a digital
copy to the city for processing.SAVE FORA PRINT FORM sugar FORM