Development Review Application&c.
COMMUNITY DEVELOPMENT DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhassen, MN 55317
Phone: (952) 227-1100 I Fax: (952) 227-1110
APPLICATION FOR DEVELOPMENT REVIEW
&l rla!-
Section 1: Application Type (check all that apply)
(Refer to the appop.iate Adication Checklist fot rcquired submittal infomaton thal must a.Eompany fi,is apglication)
tr
tr
Comprehensive Plan Amendmenl...
E Minor MUSA line for failing on-site sewers
Conditional Use Permit (CUP)
E Single-FamilyResidence
E A[ others......
E lnterim Use Permit (lUP)
E ln conjunciion with Single-Family Residence.. $325I All Others...... ..-................... $425
E Rezoning (RE4
n Planned Unit Development (PUD)....
E Minor Amendment to eisting PUD................. $100E ntt ottrers...... ...................... $500
Sign Plan Review................ ....... $150
Site Plan Review (SPR)
I ndmlnistratire ..................... $100E Commercial/lndustrial Districts*...................... $500
Plus $10 per 1 ,000 square feet of building area:( thousand square feet)
'lnclude number of e&SDg employees:*lnclude number of 4clg employees:
E Residential Districts.............-......................-.... $500
Plus $5 per dwelling unit ( units)
( ftotin""tion Sign lcity to irstan and remove)
Ksubdivision (suB)' EKcreate 3 lots or less ......
Ei- cr"rt" or"r g rot" .-..................(_ lots)! Metes & Bounds (2 lots) ...........E Consolillate Lots .. ..... .. .... .. .... ....
... $600
... $100
... $325
... $425
........... $7s0
............."...... $300
$600 + $15 per lot
D Lot Line Adiustment.............
E( il,li;i.i.-:__...._................................ ..........
(lncludes $450 escrow for attomey costs)*
'Additional escro^t may be reqllred for other applications
$300
$1s0
$1s0
$700
$300
through the developmer contract.
E Vacation of Easements/Right-of-way (VAC)
(Additional recordirE fees may apply)
Variance (VAR) ........................d.tr
tr
.. $200
fl Wetland Alteration Permit (WAP)
E Single-Family Residence..............-....--....-..... $1 50fl nt orrers...... ....................$275
E Zoning Appea1...................................................... $1OO
! Zoning Ordinance Amendment (ZOA)................. $500
!IqIE; Whell IlRlltiple applicdions ar€ prccess€d concurl€n[y,
the app|opdate fee shdl be chaE€d ior each applbatlon.
! Escrow for Recording Documents (check all that apply).....-..............
E Conditional Use Permit E lnterim Use Permit
E Vacation ffiVarianceE Metes & Bounds Subdivision (3 docs.) fl Easements L_ easements)
E\61
d1!"oJrl,"*.1
......."....'..'.... $200
..... 53 oer address
$soVp"Z, oo"rr"nt
E Site Plan Agreement
n Wetland Alteration Permit
E Deeds t.
TOTAL FEE: I c31
Section 2: Required lnformation
Description of Proposal
gt,Ar^r^^l V,,- L,-!Property Address or Location
Parcel #:
Total Acreage:
Present Zoning
Legal Description
3 Wetlands Present?
)
ns1;en. Select One
ftves E ruo
Requested Zoning:[,,,J,^k^l l-.,
SDooo
€eberone N,
Requested Land Use Designalion Select OnePresent Land Use Desig
Existing Use of Property:
ftn""* box if separate nanative is attached
Submittal Date:
CITY OT CIIAI'IIIASSII'I
lrlgl:r ec o.,., I lq I )O cc Date: ,ldL, 1aa-6oDay Review Date:
S eroperty Owners' List within 5OO' (city to generate aier pre-apptication meeting) .-.....
Se{ee€re
APPUCANT OTHER THAN PROPERTY OWNER: ln sbning this application, l, as applicant, represent to have obtained
authorization fom the property owner to file thb application. I agree to be bound by conditions of approval, subjec{ only to
the right to object at the hearings on the application or during the appeal period. lfthb application has not been signed by
the property owner, I have attacied separate documentation of tull legal capacity to fts the apdication. This application
should be processed in my name and I am the party whom the City should contacl regading any metter penaining to this
application. lwillkeep myself informed oflhe deadlines for submssion otmalerialand the progress of this applicalion. I
further understand that additional fees may be charged for consulting fees, feasibility dudies, etc. with an eslimate prior to
any authorization to proceed with the study. I cerlify that the information and e)hibits submitted are true and coned.
Name
Address
Contacl:
Phone:
City/Statezip
Email:
Cell:
Fax:
Date
PROPERTY OIYNER: ln signirE this application, I. as pmperty owner, ha\,e tu tegat capecity to, and hereby do,
authorize tie filing of this application. I understard that conditions of approval are binding and agree to be bound by those
conditions, subje.t only to the right to ob.ieci at the hearinos or during the appeel perbds. I will keep m!,sef informed of
the deadlines for submission of material and lhe pmoross of iiis application. I further understand that additionat fees may
be charged for consulting fees, feasibility studies, etc. riith an estimale prior to any authorization to proeeed with lhe
study. I certity that the information and exhibits submitted are true and corTec{.
Marv and lli chel ll€udssen
Namel ilarv l{eux,i ssencontacl:
Signature
Address: 4265 ctv rd 123 phone-
6126
Cell:
Fax,
6126705879
Email:
Signature
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<<)rf\ Dalll/ 3o/2o2l
PROJECT ENGINEER (f appli:abte)
Neme: t th' ls>. -.^["'
Address 1 t JvrF \a.ri- \hr.,I Phone:ab ) LSX 4'+LI
City/Slate/Zip B.,6J*l" t/\l.) 5S 313
Email L*r* o a lL assoe.i\.r . z.'^-
This application musl Oe compteteO in trtianO muk be accompanied by all information and plans required by
applicable cily Ordinance pmvisions. Before filing lhis application, refer to the appropriate Applicetion Checklist
and confer with the Planning Department to determine the specific ordinance and applicable procedural
requirements and fees.
A delermination of completeness oflhe applic€tion shall be made within 15 business days of application submittat. A
written notice of applicalion deficiencies shall be mailed to lhe applicanl withln 15 business days of application.
Who should receive copies of statr reports?'Other Contact lnformataon:
Name:
Address: 3
Email
Ifll
Mailed Paper Copy
Mailed Paper Copy
Mailed Paper Copy
Mailed Paper Copy L
INSIRUCTIONS TO APPLICANT: Comdevice. , and deli\er to city
copy to the city fo, processing.
plete all necessary form fields, tien select .
along with required doc{ments and paymerd
SAVE FORM PEINT FOAM
io sa\€ a copy to your
to send a digital
SUBMIT FORM
Cornaa: &^,. A \Fr
Cell:
Fax
Section 4: Notilication lnformation
$emperty Ormer Via: dEmart
Ef Applicant Via: EJEmaitEfEngineer Via: ELEmailEkofief Via: KEmait