Development Review ApplicationCOMiIUNITY DEVELOPMENT DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952\ 227 -1 1 00 / Fax: (952) 227-'1110
Submital Dale 3la,Pc Date: loa
CITY OT CHAI{IIASSII'I
APPLICATION FOR DEVELOPMENT REVIEW
Planned Unit Development (PUD)
Minor Amendment to existing eUb..
All Others.............
L\
n Vacation of Easements/Righfof-way (VAC) .-
(Additional recording fees may apply)
I Variance (VAR)...................
Ll cc Date: b 60-Day Revlew Date
(Rafer to the apprcpdate A@ication c,,lccklist fot requiBd subnittal info|nx|E,lion that mud actonDany this apptication)
Comprehensive Plan Amendment..........,.............. $600 E Subdivision (SUB)E Minor MUSA line for failing on-site sewers..... g't0O ! Create j lots or less ........_..._........................... $3OO
conditional use Permit (cuP) E create over3'ots """" "" $600 + $'15 per lot
n si^gl;r".;iry;i;rd;n".i............. F?q E Meres & Bounos 12ffi.:l:l . ...............**E Att others....... ..................... $425 Ei consotidate 1ors.....,........................................ $150rnrerimusepermit(rUp) E iil:ir#::l'"11 ...........:...:.:...... . ..:3;33! ln conjunction with Single-Family Residence.. $325 L-J
E nrr oiri"r".....-...:..:.-...:.,..:..................-....-..$42s (lncludes $450 escrow for attornev costs)*
'Additional escrow may be required for other applications
Rezoning (REZ) through the developmenl contract'
trtrtr
$750
s100
$500
$300
.. $200
n Sign Plan Review................................................... $150 ! we$and Alteration permit (WAp)
n Site Plan Review (SPR) E Single-Family Residence.............................-. $150
fl Administrative. ......... .......................... $1oO ! All Others....... ......,..-.-.-..... $275
! Commercial/lndustrial Districts*...................... SSOO
Plus$10 perl,000 square feet of builaing area, L-l zoning 4ppea| "" """ " " " """ " "$100( thousand square feet) T"l
"rncruoe number or exisdinq Jm-pl"v*1, _ Ll Zoning Ordinance Amendment (ZOA)................. $500
'lnclude number of @g emolovees:
n Residential Distncts::....................-.--__--_SSOO I(lfE: when multiple applicalions atp procsEsed concurengy,
plus $5 per dwelling unit f uniist ---- the appropriate fee shall bo charged for each application.
E- Property Owners' List within 500'lotyto generate after pre-apptication meeiing)..................-. + l'f .. ............... $3 per address/ ( 39 addresses)O Escrow for Recording Documents (check all that apply)..................... .......:=........ -...........ESO per document
E Conditional Use Permit I lnterim Use Permit n Site Plan Agreement! Vacation E Variance ! Wetland Alteration Permit! Metes & Bounds SuMivision (3 docs.) E Easements (_ easements)
Brr^"f|:a,5Et 6b
Section 1: Application Type (check all that appty)
Section 2: Required lnformation
7205 HAZELTINE BLVDProperty Address or Location
Parcel #: 253360441
Total Acreage:
Present Zoning Select One
Present Land Use Desig nr11on. Select One
Wetlands Present? E Yes Z Ho
Not Applicable
Requested Land Use Desig nr11on. Not Applicable
Existing Use of Property:RESIDENTIAL
Echeck box if separate narrative is attached
nlalsi
Description of Proposal: TNSTALLATTON OF A rypE 4 SSTS. CARVER COUNry REeU|RED
Legal Description:
Requested Zoning:
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 to file thls 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 app€al 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 mntact regarding any matter pertaining to this
application. lwill keep myself informed of the deadlines for submission of material and the progress of this application. I
further understand that additional fees may b€ 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 ROBERT BILLIET foT MID MN SEPTIC SERVICES
Address 22517 TAGUS AVE
HUTCHINSON, MN 55350
6on1""1 BOB BILLIET
Phone: QzO) 2U-7222
(320) s83-3261
Email
Signa
bob@midmnsepti c.com
ture
Cell:
Fax:
Date 913t21
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 b€ bound by those
conditions, subject only to the right to object at the hearings or during the app€al 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 lhe
study. I certity that the information nd exhibits submitted are true and conect
Name Contact
Address Phone
City/Sta
Email:
Cell:
Fax:
DateSignature
PROJECT ENGINEER (if applicable)
Name:Contact:
Phone:Address
City/State/Zip
Email:
'^lL L
pleted 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 Departrnent 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
wriften notice of application deficiencies shall be mailed to the applicant within 15 business days of application.
This application m com
Section 4: Notification lnformation
@ Property Owner Via: El EmailE nppticant Via: E] EmailE Engineer Via: ! Email
! otner Via: E Emait
n Maiteo Paper Copy
E uaiteo Paper Copy! Maited Paper copy! tvtaiteo Paper Copy
'Other Contact lnformation
Name
Address:
City/State/Zip
Email:
INSTRUCTIONS TO APPLICANT; Com plete all necessary form fields, then select SAVE FORM to save a copy to your
device. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital
copy to the city for processing
SAVE FORM PRINT FORM SUBMIT FORM
City/State/Zip:
Cell:
Fax:
Who should receive copies of staff reports?