Development Review ApplicationQtsx- (.t tL.q oh Ja_
$200
COilIIIUNITY DEVELOPMENT DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 / Fax: (952) 227-1110 CITY OI CHAI{HASSII{
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APPLICATION FOR DEVELOPMENT REVIEW
subinitbrDd!: ?/oo1Sl n*"k /,s l>t ccoa",a / t a-l >l 6GDay Reviev, Date:Ulot
Section 1: Applicataon Type (check all that apply)
E tnterlm Use Permit (lUP)
E h coniunction with Single-Family Residence.. $325E att oners...... ............. ... ...$425
(Rolet to ha qf/ryiae AIPlic ion C,€,c,did tu tqdtd
I Compehensive Plan Arnendment......................... $600! Minor MUSA line for failing on-site sewers.....$100
E Conditional Use Permit (CUP)E Single-Family Residence ................................ $325D att oners...... .......................$42s
slffid inloot,,rjo, thal md s.,,np',-y hb aniL?/lrryr)
E SuMivision (SUB)!fI
trtr
Create 3 lots or less .................--..................... $300
Create over 3 lots $600 + $15 per lot(__ lots)
Metes & Bounds (2 lots)...,..............................$m
Coosolidate Lots. ................. $150
$300
on Permit (WAP)
$150
$275
$100
E Lot Line Adjusrnent.........................................$150E Finat P1a1...................... ........$7OO
(lncludes $450 esoow for attomey costs)'
'AdditbrEl€scrqw rIlay b€ rlSrirEd b o0€r applications
Arough 0ta devdoFnenl omtacl
E Vacatlm of Easemenb/Rigtrt-of-way (VAC)........
(Addliond ,.cordng tu€s m.y ely)
E Variance (VAR)
E Wetland Alterati
Single-Family Residence
$7s0
$100
$s00
E sbn Plan Review........................-......................... $150
E Site Plan Review (SPR)
E Adminisrrawe ......................$1mI Cornmerciautndusfial Disticts'...................... $5OO
Plus $10 per 1,0(x) square feet of building area:( thoussnd square feet)
'lndude nmb.r of ldgbq employoas:
E Escmw fq Recoding Documents (cfEck all that
D ConOitionat Use PermitE vacatbnE Mdes & Bounds SuMMsion (3 docs.)
'lrdude nunb€r ol Agg €mdoF€5:
Residential Disficts.............................
Plus $5 per d,velling unit ( units)
$500
El Nomcatim Sign (city b irdar and rEmorre)
! Property Orners' List within g)0' (city ro gsncraie affer pre-appticarion rn€eting)
gE: lthen rflddph +plica0ons r]l pToc6sed conoJrrnly,
the approp.ld! ftc shCl be.rrargcd lor ..ch appllc.Oon.
$3
'6"*:T..l......, gso per dodmentE Site Plen AgreementE wetlandE oeeos
TOTAL FEE
Alteration Perrnit
.@
$soo
Section 2: Required lnformation
Description of Proposal
Property Address or Location:i0 0 Hua
parcet#: )s.S.rClI&,Legal Description:
Total Acreage:Wetlands Present? E Yes El No
Serecr one fZS F Requested Zoning . Select One
Requested Land Use Oesignation . Select One
6ie Hrlr:st
Present Land Use Desig 661;66. Selecl One
&isting Use of Property:
Echeck box if separate nanative is attached.
r
E Rezoning (REz )E Phnned Unit Development (PUD) ..................E Uinor lmenOment to existing PUO............-....E ff ottrcrs......
lnterim UsqPermit
Variance 7>o
Easements ( easements)
Pres€nt Zoning:
Section 3: Property Owner and Applicant lnformation
Name frntact:
Phone:Address:
City/Statetz ip
Email:
Cell:
Fax:
DateSignature:
PROPERW OWNER: ln signing this application, l, as property o,vner, have tull legEl 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 lhose
conditions, subjec{ only to the right to otject at the hearings or during the appeal periods. I will keep mysetf informed of
the deadlines for submissbn of material and the progress of this application. I turther understand that additional fees may
be charged for consulting fees, feasibility studi6, etc. with an estimate prior to any autlrcrizetion to proceed with f}e
I certify the information and exhibits submitted are true and
Address:OO Huautri,,g Qc{ R4Mngsgl
ei/a L- P.fr-ot;o
cofrect.
Contact
Emait: cRRe o
Signalure:
PROTECT ENGIIiIEER (if applceb)
Name:
tq. e I (' enrr^
Cell:
Fax:
Oate
Cell:
Fax:
^t
Address:
Contact
Phone:
City/Statezip:
Email:
This applicalion must be compleEd in tull and musl be accompanied by all inbrmation and plans requircd by
applicabl€ City Ordimnce provisbns. EoforB filing this applicatbn, rebr to the apFopriate Applicalbn Cfieddist
and confer with the PhnnirE DeparfiEnt to determine the specific ordinance and apdicable procedural
r€quirernents and fees.
A determination of compleleness of the application shall be made within 15 business da)6 of application submittal. A
written notice of applicetion deficiencies shall be mailed to the applicant within 15 business da)/s of application.
tryho should receiye copaes of statr rcports?
Owner Via:
Ma:
Ma:
Ma:
dEmair !
Eemait E
E emait E
Eemar E
Mailed Paper Copy
Mailed Paper Copy
Mailed Paper Copy
Mailed Paper Copy
City/Statezip
Email:
Appli:ant
Engineer
other'
Address:
INSTRUCTIONS TO APPLICANT: Com plete all necessary form fields, then selecl sAvE FoRM to save a copy to your
device. PRINT FORM end deliver to city along with required docurnents and payrnent. SUBMIT FORM to send a digital
copy to the city for processing.
SAVE FORI PRII{T FORM SUBMIT FORM
APPLICANT OTHER THAN PROPERW OWNER: ln signing this applicalion, l, as applicant, represenl to have obtained
authorization from the property owner to file this application. I agree to be bound by conditions of approval, subjecl 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 ha\e 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 submissaon of material and the progress of this application. I
further understand that additionalfees 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 ere true and conect.
study.
Name:
pnone: 1{A- ) ?o - ?43 ?
city/statezip:
Section 4: Notification lnformation
'Other Contacl lnformation :
Name: