APPLICATION
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CITY OF BOYNTON BEACH, FLORIDA
PLANNING & ZONING BOARD
SITE PLAN APPROVAL APPLICATION
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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:
Barnett Bank
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):
Miller Electric Company
Address:
P.O. Box 1799
Phone:
Jax., Fla.
(904) 354-4461
32201
(Zip Code)
FAX: 350-9166
4. Agent's Name (person, if any, representing applicant):
Ronald A. Autrey
Address:
5090 Charlemagne
Jax., Fla.
(904) 387-5417
32210
(Zip Code)
Phone:
FAX:
5.
Property Owner's (or Trustee's) Name:
Barnett Ba-nk
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T'.'
P.O. Box 44145
Address:
Jax., Fla.
32231-4145
(Zip Code)
FAX:
6. Correspondence address (if different than applicant or
agent)*:
* This is the address to which all agendas, letters, and
other mat~rials will be mailed.
PLANNING DEPARTMENT - January 1991
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7. What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, developer, contract
purchaser, etc.) General Contractor
8. Street address or location of site: 105 N. Congress Ave.
9.
Legal description of site and property control
Y",-,f W1 8~~?- ~ F a../'f'h S Co. P I- 44. <;<'
8(f. r\ 2. P~.1 /"..... ( ~: ,/..,0-/ < L/ rl- ~
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10. Int~nded use(s) of site: Bank
11. Developer or builder: Ronald A. Autrey
12. Architect: N/A
13. Landscape Architect: N/A
14. Site Planner:
15. Engineer: Riva. Klein & Partnp.r~ Mi~mi. ~1
16. Surveyor:
17. Traffic Engineer: N/A
18. Has a site plan been previously approved by the City
commission for this property?
19. Estimated construction costs of proposed improvements shown 0
this site plan: $2000.00
PLANNING DEPARTMENT - January 1991
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IV. MISCELLANEOUS
The fOllowing materials must be submitted in one (1) copy:
(check)
1. A check, payable to the City of Boynton Beach, as per th
attached fee schedule.
2. Any other engineering and/or technical data, as may be
required by-. the Technical Review Board to determine
compliance with the provisions of the City's Code of
Ordinances. .
V. CERTIFICATION
(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 t
the best of (my) (our) knowledge and belief. This applicatio
will not be accepted unless signed according to the
ins~ctions below.
LrW ILtfJ-O. 3/J5)q I
Signa ture of Owner ( s) or Trustee, , 'Da te
of Authorized Principal if property
is owned by a corporation or other
business entity..
VI.
ed Agent
3/2.0/91
Date
the above
regard to
signed person as (my)
this application.
'3 /d-5fq I
J . Date
L.
S1gnature of Owner(s) or Trustee,
or Authorized Principal if property
is owned by a corporation or other
business entity.
SPACE BELOW THIS LINE FOR OFFICE USE ONLY
Review Schedule:
Date Received
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Technical-Review Board
Planning & Zoning Board
Community Appearance Board
City Commission
Date
Date
Date
Date
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stipulations of Final.Approval:
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Other Government Agencies/Persons to be contacted:
Additional Remarks:
PLANNING DEPARTMENT - JANUARY 1991
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RIDER TO SITE PLAN APPLICATION
The undersigned as applicant for Final Site Plan Approval does
hereby acknowledge, represent and agree that all plans,
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 in
which they are approved, and any change to the same shall be deemed
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 rights
and remedies as provided by the applicable codes and ordinances of
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 PtO 'Ii. DAY OF
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APPLICANT
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