Development Review ApplicationPC,sotro- >\
COMMUN]TY DEVELOPMENT DEPART ENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 / Fax: (9521227 -1110
SubmittalDale
CITY OT CIIAI'IIIASSIN
APPLICATION FOR DEVELOPMENT REVIEW
PC Dale t t
I fz ISO cc oate: [4 rc{ I-}D 6ooay Revie* Dare: f J f S/)O
Section l: Application Type (check allthat apply)
(ReIe.lo the apprqdale Applicdbn ChecUist br tquiBd subnittal inlod6t*tn that must ac.onFqny this aPncdtion)
! Comprehensive Plan Amendment......................... $600E Minor MUSA line for failing on-site sewers ..... $100
E Subdivision (SUB)
E Create 3lots or less
E Conditional Use Permit (CUP)
D Single-Family Residence .
D At others........
Planned Unil Development (PUO) .................. $750
Minor Amendment to existing PUD................. $100
All Others.............. ............. $500
Sign Plan Review................................................... $150
Site Plan Review (SPR)
D Administrative. ................... $1OOE Commercial/lnduslrial Disticts'...................... S50O
Plus $'10 per 1,000 square teet of building area:( thousand square feet)
'lnclude number of qxililg employees: _
'lnclude number of ,row emDbve€s
D Residential Oistacts-......................------- SSOO
Plus $5 per dwelling unit ( units)
Create over 3 lots .( lots)
Metes & Bounds (2 lots)...........
Consolidate Lots...
Lot Line 4djustment........................
Finar Prat.........................................::..:::..:.... ..
(lncludes $450 escrow for attomey costs)'
'Additional escrow may be requied for other applicataons
through lhe develop.nent contract.
E Wetland Atteration Permit (WAP)
E Single-Family Residence............................... $150E Atl otners........ ................. $275
fl Zoning Appeal ......................-. $1OO
D Zoning Ordinance Amendment (ZOA)................. $500
llglE: Whcn muldpl. .pplicallonr are proc.r.Gd concln ntly,
lhe .ppfopriatc tce sh.ll be charged for each .pplicatlon.
$200
......-............... $325
...................... $425
$325
$425
a
trtrtrau
a
tr
D
lnterim Use Permit (lUP)
E ln conjunction with Single-Family Residence
! Att otners........
Rezoning (REZ)
tr!Z
E Notification Sign (city to insra and remove) ........................
E Property Owners' List within 5OO' (city to generate afler pre-apptication m€€ting)
(_!_ addresses)
@ Escrow for Recording Documents (ched( all that apply) ...........................................-...................... $SO per document- ! conoitionat u;'p";t - - ['rlir"ri, u.";#ir iJ iii" Fran egr""r"ntE Vacation [t Variance ! Wetland Aleration PermitE Metes & Bounds Subdivision (3 docs.) ! Easements 1_ easements) ! Deeds
rorAl FEE: $2,466'00
Section 2: Required lnformation
Property Address or Location
Parcet #: 250033500
Total Acreage:
Present Zoning
Legal Des$iptio n : coRN sEl/4 NEt/4 TH WLy PARALLEL W|TH S L|NE SE1/4 NE.
2.U
Select One
Present Land Use Desig
Existing Use of Property
Requested Zoning Select One
nation. Residential Low Den{ll Requested Land Use Desig nation. Residential Low Densityp
Residential CITY OFTHAilIIASSEN
Echeck box if separate narrative is attached
Ocir6
.. $3oo
per lot
! Vacation of Easements/Right-ot-way (VAC)........ $300
(Additional reco.ding fe6 may apply)
E Vanance (VAR).................................................... $2OO
$3 per address
Description of Proposal Four lot subdivision and development plan
6,480 Yosemite
Wetlands Present? E Yes Z ruo
CHA,'JHASSEI,J pLAj'lllll'Jc DEPI
Section 3: Property Owner and Applicant lnformation
APPLICANT OTHER THAN PROPERTY OWNER: ln signing this application, l, as applicanl, 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 pertaining to this
application. I will keep myself informed of lhe 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
Phone:
City/State/Zip
Email:
Cell:
Fax'.
DateSignature
PROPERTY OWNER: ln signing this application, l, as property owner, have full legal capacity to, and hereby do,
aulhorize 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 m)rsetf informed of
the deadlines for submission of material and the progress of this application. I furlher 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 lrue and conect.
Kenneth Ashfeld and Barbara Bersie-Ashfeld Ken AshfeldName
&80 Yosemite Phone 46.3 -.19,1- b?31
City/State/Zip
Email:
Excelsior, MN 55331 Cell 12--s
hfeld mapleg Fax: ./b 3-111q-,8
10t12t20Signature
Todd McLouth (Loucks Associates)Contact:
Phone:
Todd McLouth
Name
Address 7200 Hemlock Lane, Suite 300 7b3 -q1b - L7 z
City/Statezip
Email:
Maple Grove/MN/553369
Todd McLouth <TMcLouth@loucksinc.com>
b l? - ?_o7 - 2?8 (o
Who should receive copies of staff reports?*Other Contact lnformation:
fl Property Owrer Ma:
E Applicant Ma:
! Engineer Via:
E otner Ma:
Email ! Mailed Paper copy
Email ! Mailed Paper Copy
Email f] Mailed Paper copy
Email E Mailed Paper Copy
Name Tom Goodrum
Address 7200 Hemlock Lane Suite 300
city/state/zip:
Email: Tom
Maple Grove. MN 55369
INSTRUCTIONS TO APPLICANT: Com
device. PRINT FORM and deliver to city
plete all necessary form ftelds, then select SAVE FORM to save a copy to your
along with required documents and payment. SUBMIT FORM to send a digital
copy to the city for Processing PRINT FORM
This application must be completed in
applicable City ordinanc,e provisions.
and confer with the Planning Departm
requirements and fees.
A determination of completeness of the application shall be made within '15 business days of application submittal
written notice ot application deficiencies shall be mailed to the aPplicant within 15 business days of application.
refe
dire bnfoarmotiandnansccomedarequ vaplemandstUpan r by
no kt isthCteaicatintiothtoaethStcaftpnpAppproapplling
ca b e (auordcnnaacednndteelTnenStheprocedetoapplpecifi
Z
Goodrum <TGoodrum@loucksinc.com>
Address:
Contact:
Address:
Date:
PROJECT ENGINEER (if aPPlicable)
Cell:
Fax:
Section 4: Notification lnformation
SAVE FORM SUBMIT FORM