APPLICATION
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CITY OF BOYNTON BEACH, FLORIDA
PLANNING & ZONING BOARD
SITE PLAN APPROVAL APPLICATION
This application must be filled out completely and accurately and
submitted in one (1) copy to the Planning Department. ~ Incomplete
applications will not be processed.
Please print legibly or type all information.
I. GENERAL INFORMATION
1. Project Name: :5CX./7~pOeT ~'T /+UNr6"12~ QUA.)
2. Date this application is accepted:
(to be filled out by Planning Department)
3. Applicant's name (person or business entity in whose
name this application is made):
I-IV/o/7l:E12t5 RUN COAJS7eUCTIOAJ CO.
Address: :~02l7 S. C6tJC;R65S A'Jt=:,-=--
BO Y.A} TO/v bE.Ltc /../. FL. =13 4 .:3 6
(Zip Code)
Phone:
738 - 4C:;9~
FAX:
4. Agent's Name (person, if any, representing applicant):
Address:
I'f/rJ../6LLE T~MA5E:LI.J
3700 CL(.JI3I-./(':)(./.5E L4 f.iE
bOY/lJ,C)!\! h56C/..-I FL .-:j34=stO
(Zip Code)
7.':3 4 - 6. 0 OC) FAX: 7.'34 - 40 A I
Phone:
5. Property Owner's (or Trustee's) Name:
I-IOAJ TEI2.S
Address:
3G 2. S-
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Q ()A) r.O/JC;7k?UC,/()^)
COAJGR.J555 AVE
co.
0nYf.JTO A.J B6-/J.CI-I, FL .=?343G
(Zip Code)
7.~ A - 49 C) b FAX:
6. Correspondence address (if different than applicant or
agent)*:
----
* This is the address to which all agendas, letters, ani
other materials will be mailed.
PLANNING DEPARTMENT - January 1991
C:SitePlan
( 2 )
7. What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, developer, contract
purchaser, etc.) DE VEL 0 P F: R
8. Street address or location of' site: I 5oUTtIPO/.?7 L.A f\.)(=;
9. Legal description of site and property control ~:
:5 CI () 71.~./ ,c:>() 12. TAT 1-1 U ~ 75/2 S R. UN
10.
Intended use(s) of sLte:
( ,~...-1..i.h....)
AN [) gOOM AT
coIJCjTI?' (..leI
(roofd.5c.r~e.rtd enc1c
pr.;,J2G,L1
~/P6 PATIO. j
12..P Ae- 12.-00 Iv1 kDO I Tt 0"-..1 ~.
11 . Deve loper or bui lder: J-JUAJ Tc-PC::: R UJJ CO IJC:;iP UC '1 () ^ /
12. Architect: C:/-IAI2L6!5' N. GIL-f3E12..T
13. Landscape Architect:
-
14.
Site Planner:
15.
Engineer:
16.
17.
Surveyor:
Traffic Engineer:
18.
Has a site plan been previously approved by the City
Commission for this property? YES
19.
Estimated constructjon costs" of proposed improvements shown
this site plan: :!IT P.JC;Jr'")(i
PLANNING DEPARTMENT - January 1991
C:SitePlan
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iV. MISCELLANEOUS
Page 9
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The following materials must be submitted in one (1) copy:
:heck)
1. A check, payable to the City of Boynton Beach, as per the
attached fee schedule.
2. For projects that generate at least three thousand (3,000)
vehicle trips per day or two hundred and fifty (250) single
directional vehicle trips in a one (1) hour period, a traffic
~..,~~~"...:. .c:..4.4~~:Z. .:.:...: :7,~:: ~ ~~ ::~=:::i ~-=cd.
3. Any other engineering and/or technical data, as may be re-
quired by the Technical Review Board to determine compliance
with the provisions of the City's Code of Ordinances.
V.
CERTIFICATION
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(I) (We) understand that this application and all papers and
plans submitted herewith become a part of the permanent records
of the Planning and Zoning Board. (I) (We) hereby certify that
the above statements and any statements or showings in any papers
or plans submitted herewith are true to the best of (my) (our)
knowledge and belief. This application will not be accepted
unless signed according to the instructions below.
. ~~_ -;;? -A"/ .
Signai:. re of ..fK:fner(s) or Trustee,
or Authorized Principal if property
is owned by a corporation or other
business entity.
7/1 b/tj I
D aft e
VI. AUTHORIZATION OF AGENT
()u~q~~ .
~lgnature of Authorlzed Agertt
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(I) (We) hereby designate the above signed person as (my)
i~-d/gent in regard to this apPliC;~;:~q I
s-~, / tk
19n-a ture 0 Owner (s) or Trustee, Da
or Authorized Principal if property
is owned,by a corporation or other
business entity.
SPACE BELOW THIS LINE FOR OFFICE USE ONLY
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Review Schedule:
Date Received:
Technical Review Board
Planning & Zoning Board
. Community Appearance Board
City Council
Date
Date
Date
Date
Stipulations of Final Approval:
Other Government Agencies/Persons to be contacted:
Aqqition~l Remarks;
Planning Dept. 10/B2
J , '
RIDER TO SITE PLAN APPLICATION
The undersigned as applicant for Final Site Plan Approval does
hereby acknowledge,- represent and agree that all ~lans,
specifications, drawings, engineering, and other data
submitted with this application for review by the City of
Boynton Beach shall be reviewed by the various boards,
commissions, staff personnel and other parties designated,
appointed or employed by the City of Boynton Beach, and any
such party reviewing the same shall rely upon the accuracy
thereof, and any change in any item submitted shall be deemed
material and substantial.
The undersigned hereby agrees that all aspects of the proposed
project shall be constructed in strict compliance with the form il
which they are approved, and any change to the same shall be deeml
material and shall place the applicant in violation of this
application and all approvals and permits which may be granted.
The applicant acknowledges that the City of Boynton has all right~
and remedies as provided by the applicable codes and ordinances 0:
the City of Boynton Beach to bring any violation into compliance,
and that in the event of enforcement action by the City, the
applicant shall indemnify, reimburse and save the City of Boynton
Beach harmless from any costs, expense, claim,-liability or any
action which may arise due to their enforcement of the same.
READ, ACKNOWLEDGED AND AGREED TO THIS -L~ DAY OF
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APPLICANT