Development Review ApplicationCruMCIINIIASSXI{
APPLICATION FOR OEVELOPMENT REVIEW
Submittal Date rt o ""*,"llst5t "" or",,s 6G0ay Review Date rJl+r
(Retet lo lhe apptwriato Adicdion Chocklis, lor Dquitg<t subnittdl intormatbn that mud e.rnpany this dpplicatioa)
fl Comprehensive Plan Amendment s600 D Subdivision (SUB)
E Create 3 lots or lessE Minor MUSA line for tailing on-site sewers..... $100
fl Conditional Use Permit (CUP)
..........$300
Dtr Single-Family Residence $325
M25
E Create over 3 |ots.......................$600 + $15 per lot
[_ tots)
! Metes & Bounds (2 lots).................................. $300
E Consolidate Lots..............................................9150
! Lot Line Adjustnent.........................................$150
E Final P1at......... ..................$700
(lncludes 5450 escrow for attomey costs)'
'Additional escruw may be rcqul€d toa otlrer applicatbns
through *le deve{opm€nt contract.
D Vacation of Easements/Right-of-way (VAC)........ $300
(Addruoml recording fees rnay apply)
All Others.............................
E lnterim Use Permit (lUP)
D ln conjunction with Single.Family Rosidence.. S325n ett ottrers................$425
Rezoning (REZ)
A 2lanned Unit
El'Minor Amend
! Att omers......
Development (PUD)$750
$100
$500
ment to existing PUD
(arianceUen)920O
E Sign Plan Review.......................
E S e Plan Review (SPR)
s1s0 ! Wetland Alteration Permit (wAP)
E Administrative.......s100
trtr s150
s275
$100
$500
E CommsrciaUlndustrial Districts*...................... $500
Plus 010 per l,ooo square reet oi uuiioiil;;' -- Ll zoning App€al
( thousand square feet)
'lnclude number of glqlEg emplo!€€s: _D Zoning Ordinance Arnendment (ZOA)................
a 'lnclude number of &q eandoyees:
ffi:i*f l?lxmC;;;-:f I/mr",;mrlg*igff ffi'?ffi #'ffi :*''
$200
El Property Owners' List within 500' (city to gene.at€ 6ller Ee-appllcatbn meeting)$tD ...... $3 per address
. $50 per document
Agreement
dloep E-scrow for Recording Documents (check a
.tfieondition at Use Perm it
Ll Vacation
E Metes & Bounds SuMivision (3 docs.)
ll that apply)!tr
lnterim Use Pormit
Variance
Easements L easements)
E wetand Alteration Permit
*'Kli., z33otr
Description of Poposal: 1 10 Unit Apartment Building for Affordable and Market rate Senior
Prop€rty Address or Location
Parcel #: 25636@20
1361 Lake Drive West
Total Acreaga:3.68
Present Zoning:Planned Unit Developrnent (PUD)Requested Zoning Planned Unil Developrnent (PUD)
Present Land Use Designation . Residential High Densit)
Existing Use of Property:Land is currently vacant
Section 1: Application Type (check all that apply)
Section 2: Required lnformation
lcheck box if saparate narrative is attached.
Requested Land Use Desig nation. Residential High Density
CO,II UI{ITY DEVELOP ENT DEPART ENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 / Fax: (952) 227-1110
E Notification Sign (city to instal and lemove) ...................
Site
Legal Description:
Wetlands Present? E ves Z No
Section 3: Properly Owner and Applicant lnformation
APPLICANT OTHER THAN PROPERTY OWNER: ln signing this application, l, as applicant, represent to have obtained
authorjzation from the property ownsr 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 th6 appeal period. lf this application has not been signed by
the property owner, I havs attached separate documentation of lull 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 koep mysetf 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, faasibility studies, etc. with an estimate prior to
any authorization to proceed with the study. I cortify that the information and exhibits submitted ars true and conect.
Name: TPS Holding LLC Contact: Todd l/. Simning
Address 350 Hwy 7, Suite 218 Phone
(612) 590-8099
Signature Todd M. Simning Otrrrry rlmd t ldr, M SrmirE
Od6: 2@0.10 l,a 13:54 57 SS'
PROPERTY OWNER: ln signing this application, 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, subiecl only to the right to obiecl 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 hat additional fees may
be charged for consulting fees, feasibility studies, etc. with an ostimate prior to any authorization to proceed with the
study. lcertify that the information and exhibits submitted are true and consct.
Name:
Cell:
Fax:
Contact:
Phone:
Cell:
Fax:
gon164 Matl Pavek
Phone: (612) 615-0060
Cell:
Fax:
Address:
City/Statefzip:
Email:
Signature
This application must be completed in full and must be accompanied by all infomation and plans required by
applicable City Ordinance provisions. Before filing this application, refer lo the appropriate Application Checklist
and confer with the Planning Department to determine the specilic ordinance and applicable procedural
requirements and fees.
A detsrmination of completeness of the application shall b€ made within 15 business days of application submittal. A
written notice of application deficiencies shall be mailad to the applicant within l5 business da)€ of application.
PROJECT ENGINEER (if applicable)
Name: Civil Site Group
Address:4931 W 35th Street
city/state/zip:St. Louis Park, MN 55416
Mpavek@ civilsitegroup.comEmail
Section4: Notification lnformation
Who should rrcoivo coples of staff reports?
I Property Owner Via: D Email ! tvtaited Paper Copy
'Otter Contact lnfomation:
Name: Peter Jesh
E appticant Via:E Engineer Via:E Otref Via:
Address:
City/State/Zip:! Maiteo Paper Copi Email:oeter.iesh@ silve rseekeouitu.mm
copy to the city for processing.
PRINT FORTI SUBMIT FORi,l
Email
Email
Email
tru Mailed Paper Copy
Mailed Paper Copy
City/State/Zip: Excelsior, MN 55331
E."11. todd@ ador-homes.mm
Dajc. 1ol't4l2o
Date: _
INSTRUCTIONS TO APPLIGANT: Complete all nocessary form fi6lds, then select SAVE FORM to save a copy to your
device. PRINT FORM and deliver to city along with roquired documents and payment. SUBMIT FORM to send a digital
SAVE FORM