Development Review Application7
COMMUNITY DEVELOPMENT DEPARTMENT
1 Planning Division —7700 Market Boulevard CITY OF CIIAN}L&SSNMailingAddress—P.O. Box 147, Chanhassen, MN 55317 IPhone: (952) 227-1300/Fax: (952) 227-1110
APPLICATION FOR DEVELOPMENT REVIEW
i`
JSubmittalDatip-S( Q / a4-- PC Date: CC Date:(,/ /w 60-Day Review Date:
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)
El Minor MUSA line for failing on-site sewers $100 Create 3 lots or less 300
El Create over 3 lots 600 + $15 per lot
El Conditional Use Permit(CUP) lots)
Single-Family Residence 325 El Metes & Bounds (2 lots) 300
All Others 425 Consolidate Lots 150
Interim Use Permit(IUP)
Lot Line Adjustment 150
In conjunction with Single-Family Residence..$325
E Final Plat 700
Includes $450 escrow for attorney costs)*
425AllOthers Additional escrow may be required for other applications
through the development contract.
El Rezoning (REZ)
El Planned Unit Development (PUD) 750 El Vacation of Easements/Right-of-way (VAC) $300
El Minor Amendment to existing PUD 100 Additional recording fees may apply)
All Others 500
El Variance (VAR) 200
El Sign Plan Review 150
Wetland Alteration Permit (WAP)
El Site Plan Review(SPR) El Single-Family Residence 150
El Administrative 100 El 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 existing employees:
CI Zoning Ordinance Amendment(ZOA) 500
Include number of new employees:
Residential Districts 500 NOTE: When multiple applications are processed concurrently,
the appropriate fee shall be charged for each application.
Plus $5 per dwelling unit(units)
Notification Sign (City to install and remove) 200
Property Owners' List within 500' (City to generate after pre-application meeting) 3 per address
addresses)
Escrow for Recording Documents (check all that apply) 50 per document
Conditional Use Permit El Interim Use Permit Site Plan Agreement
Vacation Cl Variance Wetland Alteration Permit
Metes & Bounds Subdivision (3 docs.)El Easements ( easements) Deeds
TOTAL FEE: 7 CX)
Section 2: Required Information
Description of Proposal: Three lot residential subdivision
Property Address or Location:6760 Minnewashta Parkway
250051600 See Attached
Parcel#: Legal Description:
Total Acreage: 2.71 Wetlands Present? El Yes ll No
Present Zoning: Single-Family Residential District(RSF) Requested Zoning: Single-Family Residential District(RSF)
Present Land Use Designation: Residential Low Density Requested Land Use Designation: Residential Low Density
Existing Use of Property: Single Family Home
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: Laketown Builders. LLC. Contact: Harold Worrell
Address:
PO Box 89 Phone: 612) 501-8813
City/State/Zip:
Waconia, MN 55387 Cell: Same
Email: Harold@LaketownBuilders.com Fax:
Signature: r Date: c5/ 2_4efc-r)
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: Dale VVllenbring Contact
Address: PO Box 89 Phone: 952) 715-2926
City/State/Zip:Waconia. MN 55387 Cell:
Email: Dale@LaKe o nrnBuilders.com Fax:
2J}
1 2-Signature: p
I Date: 5
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.
PROJECT ENGINEER(if applicable)
Name: Campion Engineering Services Contact: Marty Campion
Address: 1800 Pioneer Creek Center Phone: 763)479-5172
City/State/Zip: Maple Plain, MN 55359 Cell: 763)486-3799
Email: mcampion@campioneng.com Fax:
Section 4: Notification Information
Who should receive copies of staff reports? Other Contact Information:
El Property Owner Via: El Email El Mailed Paper Copy Name:
0 Applicant Via: El Email El Mailed Paper Copy Address:
0 Engineer Via: El Email Mailed Paper Copy City/State/Zip:
El Other* Via: El Email El Mailed Paper Copy Email:
INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your
device. PRINT FOr.. and deliver to city along with required documents and payment. SUBMIT FORA to send a digital
copy to the city for processing.SAVE FORM PRINT FORM I SUBMIT FORM
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.
1,/
1.6 Name:
I
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j
Contact:4 K
Z Address: h31 (o,,,,c al01-1's Utz.—Phone: V) YFLI f° 11
1City/State/Zip: -E cji ,,,A r 'LU' j_5. (Cell:
Email:
j Fax:
ySignat re ,
t A-4\/„....4.1.e (.amu Date: 111y1/ 'f
This appli ion 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: Campion Engineering Services, Inc. Contact: Marty Campion
Address: 1800 Pioneer Creek Center Phone: 763)479-5172
City/State/Zip: Maple Plain, Mn 55359 763)486-3799tYPCell:
Email: mcampion@campioneng.com Fax:
Section 4: Notification Information
Who should receive copies of staff reports? Other Contact Information:
EProperty Owner Via: 0 Email 111Mailed Paper Copy Name: Harold Worrell
Applicant Via: Email Mailed Paper Copy Address:
Engineer Via: E Email Mailed Paper Copy City/State/Zip:
Other* Via: Email Mailed Paper Copy Email:Harold@LaketownBuilders.com
INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, then select SAVE FORM to save a copy to your
device. 77.1;,7 FORT'!: and deliver to city along with required documents and payment. SUBMIT FORK: to send a digital
copy to the city for processing.
SAVE FORM 1 PRINT FORM SUBMIT FORM