Development Review ApplicationQC 2t- tQ nv",t
COMMUN]TY DEVELOPMENT DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227- 1 100 / Fax: (952) 227-1110 CITY OT CIIII{HISSII{
APPLICATION FOR DEVELOPMENT REVIEW
(Refet to the W@priate Applbdhm checuis, tor tquhed submittal infoflr,ation that mug- @ wnyu1,is applbalidt)
E Comprehensive Plan Amendment......................... 9600E Minor MUSA line for failing on-site sewers ..... glOO
E Subdivision (SUB)
! Create 3 lots or less ...........$300
E Conditional Use Permit (CUP)
E Single-Family Residence ..E Al others......
E Create over 3 lots ...$600 + $15 Per lot
$325
$425
I Metes & BoundsE Consolidate Lots
(
(2 lots) ....:::l ................... $300
I tnterim Use Permit (lUP)
E ln conjunction with SiE alt otners..................
ngle-Family Residence..$325
$425
E Lot Line Adjustment.........
E Final P1a1..........................
...$150
...$150
... $700
E Rezoning (REZ)
E Phnned Unit Development (PUD) .............Ll Minor Amendment to existing PUD............! ett otners......
... $750
... $100
... $500
(lncludes $450 escrow for attomey costs).
'Additional oscrow may bs Equirrd for othe. apptications
tiough the developrnent contrad.
E Vacation of Easements/Right-of-way (VAC)........ $3OO
(Additioml tEcoding fees may apply)
EJ Varianc€ (VAR). $2ooE Sign Plan Review............. $150 E Wetland Alteration
E SingleFamilyE rut otners.......
E Site Ptan Review (S
E Administrative...
PR)
Permit (WAP)
Residence....... $150
. $275
. $100
. $500
! Commercial/lndustial Districts'...
.............. $100
.............. $500 ! Zoning Appea|........................Plus $10 p6r 1,000 square feet of building area:( thousand square feet)tlnclude numbor of glglhg emptoys€s:
'lnclude number of 4gg employeei:
E Zoning Ordinance Amendment (ZOA).....
tr Residential Districts......................... $s00 !!!IE: When multlplo appllcations aro procossod concur6n{y,
the app.opriato foo shall b9 charged for elch application.Plus $5 per dwelling unit ( units)
f, ruomcation Sign (city to insral and r6mow) . . . . ......... $200
[l Property Owners' List within 5OO' (City to gercrare afte. prB,apptication meetins) ...... $3 per address
D Escrow for Recording Documents (check aE Condltional Use Permit
! Vacation
! Metes & Bounds Subdivision (3 docs.)
( z.l addresses)
ll that apply)...............
E lnterim Use Permit
............... $50 per document
trn Variance
Easements (_ easements)
E Site Plan Agreement
E Wetland Alteration Permit
E Deeds f ..
TOTAL FEE: -/r
Description of Proposal:
Property Address or Location:
Parcfll#: ? ;-ILDTD1AO LegatDescription:o
Total Acreag e: ?.46 Wetlands Present?EvesEruo L o-f Oo c<O
Present Zoning:Selec-t One (e.51 J Requested Zoning . Select One " l&)o I
Presenl Land Use Desig nation. Selec,t One Requested Land Use Designatio
Existing Use of Property:
Application Type (check all that apply)Section 1
Section 2: Required lnformation
fiCtrecf Oox if separate narrative is attiacfred
n. Select One
v^i
.,**,*,',7 / tG / 3-( ,co.",8 l11 [-,]L ccDa,'g./!3L}L 6&oayRevbwDara:Tl,qt tt
Section 3: Property Owner and Applicant lnformation
APPLICANT OTHER THAN PROPERTY OWNER: ln signing this application, l, as applicant, represent to have obtained
authorization from the property owner lo 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 offull 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 wilt keep m)6etf 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 intormation and exhibits submitted are true and conect.
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U
City/State4i
email: /{t
p 5933 q9z- 21 2 - 4730
sQ/L,.\2-n 00. L4 Fax:
DateSignature:
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, subject only to the right to object al the hearings or during the appeal periods. I will keep 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, feasibility studies, etc. with an estimate prior to any authorization to proceed with the
study. I certify that the information and exhibits submifted are true and conect.
Na ,",:t4Son F T44.4 Sfr-rn Yra,'*t1 Contact:n
Address:I Pho
ci o Cell:
Fax:
Date
L 1,5- o
I . cow)Email:
Signature:
PROJECT ENGINEER (if applicable)
Name:Contact
Phone:Address:
Cell:
Fax:
E Property Owner Via: E Email
E Applicant Ma: E Email
! Engineer Via: E Email
E Omef Via: E Email
D uaiteo Paper copy
f| Maited Paper Copy
E Mailed Paper Copy
fl Mailed Paper Copy
Address:
INSTRUCTIONS TO APPLICANT: Com plete all necessaryform fields, then select SAVE FORM to save a copy to )rour
device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to se nd a digital
copy to the city for processing.
PRINT FORM suBmlT FoRl{
or
I
This application musl 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.
Section 4: Notification lnformation
City/State/Zip:
Email:
conracr',Ll,zLL-Jla-a-fu rA-
Phone: _
Name:
Address:
Citv/StateZio:
Email:
Vl2b I '- |
Who should r€celve copies of staff reports?'Other Contact lnformation :
Name:
SAVE FORM