Development Review ApplicationCOHMUN]TY OEVELOPI'ENT DEPARTi'ENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1 100 / Fax: (952) 227-11'lO
SubmittalOate I APPLICATION FOR DEVELOPMENT REVIEW
6SDay Review Oate
Section 1: Application Type (check all that apply)
fl ComprehensivePlanAmendment.........................$600 E Subdivision(SUB)
D Minor MUSA line for failing on-site sewers..... $100 E Greate 3 lots or less
D Conditional Use Permit (CUP)
trn Single-Family Residence ..
All Others................
E lnterim Use Permit (lUP)
ln conjunction with Single-Family Residence.. $325
All Others............ ................ $425
E Rezoning (REz)!tr
Planned Unit Development (PUD) .
Minor Amendment to existing PUD
... $7s0
... $100
... $500n ntt otrers.................
E Sign Plan Review.
E Site Plan Review (
E Administrative
... $325
... $42s
trtr Final Plat.
(lncludes $450 escrow br attomey costs)"
'Additional esdow may be required for other applications
throllgh the det slopment contrad.
E Vacataon of EasementvRight-of-way (VAC)........ $300
(Additbnal Gcording tu€6 may apply)
E Variance (vAR).................................................... $200
$150 n wethnd Atteration permit (wAp)
E Create over 3 1o8.....................(_ tots)E Uetes a Bounds (2 lots)...........
E Zoning Ordinance Amendment (ZOA)
$45
..................... $300
$600 + $15 per lot
$300
$150
$150
$700&tr
SPR)
........'..................... $100
! Single-Family Residence......
E Ari ffi;.-.:...--.--..--..........................
$1s0
$275
............ $100E Commerchl/lndustrialDistricts'......................$500 r..1,
Plus g10 per 1,ooo square reet oi ilil;iil ;.;, -- Ll zoning Appeal
( thousand square Eet)
lndude number ot gxigDq employe€8:
'lnclude number of 4g!I employess:E Residential Districls......................................... $500
Plus $5 per dwelling unit ( units)
llglE: Whrn multipl. .pplioltiolt3 ar. PIoo!5s.d omourEndy,
th. $propdab l. Ehdl ba ohxlEd ior..oh .pplio.tion.
s500
................ $200
$3 per address
# XoUnaai- Sign (city to instal and rqrov6) ........ .....
E Property Owners' List within 500' (clty to gEnerac der pr€-applbatbn meeting) .
Ei Escrow fior Recording Documenrs (check ar that ?pply)........................ --t-.:tj:*]]....... sro per document
E Conditional Use Permit E[ lnterim Use Permit E Site Plan Agreement
E Vacation E Variance E \fietland Alteration Permit
E Metes&Boundssubdivision(3docs.) E Easements( qrsements)
Brfflia, 6ZO-z
Section 2: Required lnformation
Description of Proposal 7c€ P8q:ry-
/ififuCffiroN
Property Address or Location
Parcel#: /
t/'
l/'
Present Zoni
Present Land
Existing Use of Property:
Legal Description:
wedands Present? E Yes No
Requested
Select One Requested Land Use Desig
+tDtA{
Select One Selecl One
One
Echeck box if separate nanative is attached
Itz l)l eco*",ldIrq\]t ".o*".|t l( l+i tr /rc I rr
(Reter to tl?p apptqnab Applk at*n Cl?s,c*tisl tor IequiB,d suhnifial inlomatin that musl @o$any tlis applbatin)
,/'
Totel Acreage:
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 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 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 contact regarding any matter pertaining to this
application. I will keep myself informed of the deadlines for submission 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 inbrmation and exhibits submitted are true and correcl.
Name:
Address
Contact:
Phone:
city/state/zip:
Email:
Cell:
Fax:
Signature Date:
PROPERW OWNER: ln signing this application, l, as property owner, have tull 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 at the hearings or during the appeal periods. I will keep myself inbrmed of
the deadlines for submission of material and the progress of this application. I further undertand that additional Ees may
be charged fior consultjng 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 conect.
Name u\ 44r'D conact:51't+b^)
Address:pnone: bl7- 1%?ob
NCity/State/Zip
Email: DPfr l
Signature:Date:*02o4
Cell:
Fax:
Cell:
Fax:
N
Contact:
Phone:
a cota
This application must be completed in full and must be accompanied by all inbrmation and plans required by
applicable City Ordinance provisions. Bebre filing thas application, reEr to the appropriate Application Checklist
and confer wih the Planning Department to determine the specific ordinance and applicable procedural
requirements and Ees.
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
Who should receive copies ot stafi rsports?'Othor Contact lnform.tion:
trtrtr
! trlaiea Paper Copy NameE Email
E Email
n Email
n Email
Address:trtrtr
Mailed Paper Copy
Mailed Paper Copy
Maibd Paper Copy
City/State/Zip
Email:
II{STRUCTIONS TO APPLICANT: Complete all necess:lry form fields, then select SAVE FoRM b save a copy to your
device. PRINT FORM and deliver to city along with required documents and payrnent. SUBMIT FORM b send a digital
copy to the city for prccessing.
SAVE FORM PNINT FORM SUBiIIT FORU
PROJECT ENGINEER (if applicable)
No-o.
Add.*.
citv/state/zio:
E-oil.
Property Owner Via:Applicant Ma:Engineer Via:Othef Via: