APPLICATION
City
APPROVAL APPLICATION
: .
Beach, Florida
ning and Zoning Board
',#
.
This application rnu t 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 ype all Information.
I. GENERAL INFORMATION
'.
1. Project Name: l-cL
~LGroV~
2.
Date this Applicati n is Accepted :
(to be filled out b planning Dept.)
3.
Applicant's Name (p rson or business
application is made :
Q+o.--+
I~I
1>
entity in whose name this
, -
:-e.. .s T
's,-f StreeJ
M-v<\ OeQ --=r- \,
S 'l ~ S'l / [1
3:JLfn
- ,.' ...., . ....
Address:
,
Phone:
4.
Agent's Name
Address:
33 35 '
Phone:
, 5. Property Owner's (
'.
Name:
Address:
ofT\.~ c"
s;" Cl ~\ aJ t Of\ A- -tt- ~ro
It.-I. ' 3~YOCj
Phone:
6. Correspondence Ad ress (if different than applicant~agent)
* .
.
* This is the ddress to which all agendas, letters, and
other materi ls will be mailed.
Planning Dept. 10/8
''''-.,
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Page 2
7. What'is applicant's i
C'u
~
"
in the premises affected?
CAtrDctc
9.
(dwner, Buyer, ~ ssee, Builder, Developer,
Contract purchas r, etc.)
8. street Address
'rl (pm
tion of Site:
'Lf:- taAd
',-
Control #:
~
I a ~ l-o.. LOren c..e .ff rD V~ PI at- On~
.. .
10. Intended Use(s) of SOte: s~te_ - -+'CUy" ''j ~br(1{'..s
11. Developer or Builder K.. +b\JrlCt(\~ Ctt\ Co0'\PQJII C..s
'D ' t= \0 r \60. --r e..
12.
13.
14.
15.
16.
17.
18.
. '
Architect:
Landscape Architect: '
Site Planner:
Engineer:
Surveyor:
Traffic Engineer:
Has a site plan beGn previously approv~d
for this property?
.
by the City council
19. Estimated constructi
this site plan: $
propo~;,'d impl:ovemar. ts sho\.m on
.CO
Planning Dept. 10/82
IV.' MISCELLANEOUS
Page 9
(check)
, ()ft/ 1 .
The following m
must be.~submitted in one (1) copy:
A check, payabl to the City of. Boynton Beach, as per the
attached fee sch dule.
'~I
2. For projects th t generate at least three thousand (3,000)'
vehicle trips p r day or two hundred and fifty (250) single
directional veh cle trips in a one (1) hour period, a traffic
i4..,~~~t 'Cl''''44::'~i ~~.:; :u~~t be =~=i ttod.
3. Any other engin ering and/or technical data, as may be re-
quired by the T chnical Review Board to determine compliance
with the provis ons of the City's Code of Ordinances.
V. CERTIFICATION
,.
(I) (We) understa d that this application and all papers and
plans submitted h ewith become a part of the permanent records
of the Planning a Zoning Board. (I) (We) hereby certify that
the above stateme ts and any statements or showings in any papers
or plans submitte herewith are true to the best of (my) (our)
knowled e and bel ef. This application will not be accepted
unle Signed~c/ ,r~tg _to the instructions below.
_ ~c '-1, ~, . L-c . r1/a7!@ 1
gnature 0 Owne ~ or Trustee, Date
or Authorized Pri cipal if property
is owned by a cor oration or other
business entity.
VI.
<--'Y'
Agent
~tk1Y'1
(I) (We) hereby designate the above signed person as (my)
(OUr~~horiz~ ~en in regard to this application.
~I~~t~~) /' ~/{)1/81
SJ.gnature of Owne (s) 0 Trustee, . Date
or Authorized PrO cipal if property
is owned by a co poration or other
bus ines s e,n ti ty .
LOW THIS LINE FOR OFFICE USE ONLY
Review Schedule:
Date Received:
Technical Revi Board
Planning & Zon' 9 Board
Community Appe rance Board
City Council
Stipulations of Final Approval:
Date
Date
Date
Date
,
Other Government Agen ies/Persons to be contacted:
Additional Remarks:
P1anninq Dept. 10/82