Development Review ApplicationPc r+-o5
CO f UN]TY OEVELOPTEI{T DEPARTMENT
Planning Division - 7700 Market Boulevard
Mailing Address - P.O. Box 147, Chanhass€n, MN 55317
Phone: (952) 227-1100 / Fax (952) 227-1110
"o"-o*3)rd la:-PC Oate:
.+
APPLICATION FOR DEVELOPMENT REVIEW
CITY OT CIIAI'IIIASSII'I
s lq I r>*rr*oo,o*Sl]:aLl\l CC Oate:
Section l: Application Type (check all that apply)
(M. to tE ewq.bE Applirbn ClEcUid lot tcquhd subnittal info'mal*x1thd mus, @irpany this ap{irrdtoo)
E Co.npreherEi\re Plan &nendm6r .
E Minor MUSA line ior failing on-site seurers
fl Conditirnal Use Permit (CUP)
E Single-Family Residence $32s
il25E lu oners.......
E lnterin U$ Pemit 0UP)D ln coniunclion with Single-Family Residence.. $325E ntoners....... ....................$425
El Rezoning (REz)! Planned Unit De\r6lopment (PUD)$750
trtr All Others.
Minor Amendment to existing PUD................. $1m
E Sign Phn Review....
E Site Ptan Review (SPR)
! Create over 3 bts $600 + $15 per lot(_tds)
E U€fes & Born& (2 lots).................................. $300
! Lot Line Adjustrnent
! Final Plat
(lnctudeo $450 escrow br atbmcy coste)'
'Addliil|d cl.I rllly b! ]lqrtd br dE applcrtiqE
0ro0gh t E detdop.rsf confsd.
! Vacation of Easernents/REhtof{rey (VAC)........ $300
(Addfton8l rrcodrE b€! may ACy)
$5oo E Variance (VAR)$200
s150 E Wethnd Alteration Permil (WAP)
n Single-Family Residence......
... s600
...$1m
! Subdivision (SUB)
! Create 3 lds or less $300
$150
$150
$700
n!
E Notification Sign (city to irBta{ and tE nore)
n zoning Appeal
! Zoning Ordinance Amendment (ZOA).................
!!gIE: Whco multlpb.Dpucdom.D proc-t d concutt [dy,
tho approp.Lta tag ghrll b. chrgad ior cach rppllcaUoll.
Administrative...... .............. $100
cornmefciaulndustrial Distric$'...................... $500
PIus $10 per 1,000 square feot of building area:( thorsend square feet)
1ncub n nb€. ol !!5@ cmplo}let:
'lndude nu,nber of 4C! erndoye6
! Resilenthl Districls.$s00
Plus $5 per d,n elling unit ( units)
$150
$275
$100
$s00
$200
E Property otrnero' List within sfi)' (ciy !o gnprrb Jrr Flrpprcdion ;il;;i ..$3 per addr*s
Use Permit
Variance
Easements (_ easements)
E Site Plan Agreernent
! Wbtland Atteration Permit
l-'l oeeos
6rag ree, 5615.00
$50 per document
Section 2: Required lnformation
Descridbn of PropGal: l'd like to replace and lengthen existing fence with a 6ft tall white vinyl orivacy fence. I would
follow current setback angles seen in attached Cert of Survey.
204 W 77th StreetProperty Address or Location:
Parcel #: 250122500 See Description on Cert of SuNey
Total Acreage:0.19 Wethnds Present? n Yes U No
Presenl Zoning:Single-Family Residential Olstrict (RSF)Requested Zoning Select One
Present land Use Oesignation:Residential Medium Der Requested Land Use Designation Select One
Existing Us€ of Property:Single Family Residence
fl Escrow for Recording Oocumonts (ch€ck allthet
E Conditional Use Pennit
E vffitbn
E Metes & Boun& Subdivisbn (3 docs.)
Legal Description:
Echeck box if separate nanative is attached.
Section 3: Property Owner and Applicant lnformation
APPUCAI{T OTHER THAN PROPERTY OWilER: ln signing this appllEtion, l, as applicant, reprBent to have obtained
authorization from the propeo o^mer to file thas applicdion. I agree to be bound by conditaons of approval, subjec;t only to
the right to ob,ect at the hearings on the applicdbn or during the appeal penod. lf this appliSion has not been sitJned by
the property owner, I have dtached seperate documentatbn of full leg6l capacity to ftle the applicetion. Thb application
should be proc6sed in my neme and I am the party whom the City should contact regardirE any matter penaining to this
applkztbn. I will ke€p m)6€[ informed of the deadlines for submission of material and the progress ol this application. I
further understand that additionalfeos may be charg€d 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 corecl.
Name:
Address:
City/Statezip
Email:
Cell:
Fax:
Signature:
PROPERW OWNER: ln signing this applk:ation, l, as property owner, have full legal capacity lo, and hereby do,
authoEe the filing of this application. I understand that conditions of approval are binding and agree to be bound by those
conditions, subjecl only lo the rigfrt to ob,iect at the hearings or during the appeal p€rbds. I will keep mlaef anformed of
the deadlines for submission of material and the progress of this applicatirn. I further understand that additional fees may
be charged for consutting fees, feasibility studies, etc. with an eslimate prbrto any authorization to proceed with the
study. I c€rtify that the information and exhibits submitted are true and conect.
Name:BENJAMIN CAMPION Contacl:
Phone:Address:204 WEST 77TH STREET (952) 217-772s
City/State/Zip:
Email:
CHANHASSEN MN 55317 Cell:
Fax:BENJAMINJCAMPION@GMAIL.COM
sig n"1ur". Ben Campion Cl'ti.lt 3ln.d !, &. C.hpir
Date:3t1612?o3r. 2022 03 16 13 15 05-0500
This +plicatbn must be complet€d in full and must be accornpanied by all infiormatbn and plans Gquired by
appliceble City Ordinanco provisions. Bebre filing this applicaton, refer to the appropriate Appli€tion Chedlist
and conter with th6 Planning Departrnent to determine the specific ordinance and appli:able procedural
rcquirenrenB and fe6.
A determinatbn of cornpleteness of the applicdion shall be made withan 15 businBs days of application submittal. A
written ndkE of applicetion d€ficiencies shall be mailed to the appli€nt within 15 business da)6 of application.
PROTECT ENGINEER (if appli=ble)
Contact:
Phone:
Cell:
Fax:
Who should r€caive coplss of staff t€ports?'Other Contact lnformation :
! Mailed Paper copy Name:!!tr
Maihd Paper Copy
Mailed Paper Copy
Mailed Paper Copy
Addre6s:
INSTRUCTIONS TO APPLICANT: Complete all necessary form fields, th€n select SAVE FORM to save a copy to your
devbe. PRINT FORM and deliver to city along with required documents and payment. SUBMIT FORM to send a digital
PRINT FORM SUBfIIIT FORII
Section 4: Notificataon lnformation
E Property Owner Via: E Email
E eppn:ant Ma: E Emailn englne€r Ma: E Emailtr otter' Ma: E Email
city/s-tatezip:
Email:
Conbd: _
Phone'
-
N*o'
A#^o'
crwrstatezip:
Email:
SAVE FORMcopy to the city for processing.