APPLICATION
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SITE PLAN APPROVAL APPLICATION
City of Boynton Beach, Florida
Planning and Zoning Board
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This application must be filled out completely and accurately
and submitted in one (l) copy to the Planning Department. Incomplete
applications will not be processed.
Please Print Legibly or Type all Information.
I. GENERAL INFORMATION
1.
Project Name:
~NS
V&\-{i--1Tet-..1
CH~~Ol.J
A UIO TlZ-o N I e-s
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2. Date this Application is Accepted :
(to be filled out by Planning Dept;)
3.
Applicant's Name (person or business entity in whose name this
application is made): .
E3a{mafl SitwlMoAn;nmJc .
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732--s{'""72--
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Phone:
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4. Agent's Name (person, if any, representing applicant):
D Av 10 \Oe-f\ 6l-~
Address: -H44 ~.vJ\ 3u-rH p...'o} ENu~ :tB
t30-ft--t,w -\-'.)ct'\C+\ \-=l.-O ~lOV\ '3 3~ ""2.J...
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Phone:
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'1"'110
s. Property Owner's (or Trustee's) Name:
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Address:
Phone:
6. Correspondence Address (if different than applicant or agent) *:
Ac"l t::\..h- ·
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* This is the address to which all agendas, letters, and
other materials will be mailed.
Planning Dept. 10/82
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7. ~'1hat is applicant's interest in the premises affected?
Ow tJe-rL
(Owner, Buyer, Lessee, Builder, Developer,
Contract Purchaser, etc.)
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8.
Street Address or "Location of Site~
9. Legal Description of Site: La-r-;R\9 J, 20 ~oBI1-\Set--' ~nPlnq.J
10. Intended Use{s) of Site:
p"v H..I N. C..
ON
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\?u\l-{)I~ ("\ To P-Al2-\L Ow N. C12-S CAIZ-
ll. Developer or Builder: G ~Gt'2...C"t 'E: LuL...J Ef2-'-\OL>S E: Lt9t..l$T\LUL-T\ eN. l'"k:..
_'441 S.w. '30,.-...1 p..~E.NLi::- ita ~m-efo..l PEAc..H Ft-~OA 33-1zJo
12. Architect:
"'D A ~h D t3 q!\ So L-E::"1
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13. Landscape Architect: \\.\A
14. Site Planner: ~A
15. Engineer: \-\ f)
16. Surveyor: CWIt\~ 1~" I~~ Sul2.\J~O~
17. Traffic Engineer: ~\A
18. Has a site plan been previously approved by the City Council
for this property? '( 1iS'$
19. Estimated construction cost of proposed improvements shown on
h' ~ I~ 0_0
t ~s site plan: 'If '""~
Planning Dept. 10/82
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II. SITE DATA
The following information must be filled out below and must appear,
where applicable, on all six (6) copies of the site plan.
l. Land Use Cateqorv shown in
the Comprehensive Plan
2. Zoning District
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3. Area of Site
sq. ft.
acres
4. Land Use -- Acreage Breakdown
a. Residential, including
surrounding lot area or
grgunds
acres
% of site
b. Recreation Areas *
(excluding water area) co
% of site
acres
c. Water Area
.% of site
acres
d. commercial
% o-f site
acres
e. Industrial
acres
% of site
f. Public/In-
stitutional
acres
% of site
g. Public,Private, and Canal
Rights-of-Way
h. Other (specify)
% of site
acres
acres
% of site
i. Other (specify)
acres
% of site
"
j. Total Area of Site
100
% of site
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* Including open space suitable for outdoor recreation, and
having a minimum dimension of 50 ft. by 50 ft.
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5. Surface Cover
a. Ground Floor Building
Area ("building footprint")
sq.ft.
% of site
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b. ~vater Area
sq.ft. % of site
c. Other Impervious Areas,
including paved area of
public & private streets,
paved area of parking
lots & driveways (ex-
cluding landscaped areas),
and sidewalks, patios,
decks, and athletic
courts.
sq. ft. !S 0 f site
d. Total Impervious Area
sq.ft. % of site
e. Landscaped Area Inside
of Parking Lots
(20 sq.ft. per interior
parking space required--
see Sec. 7.5-35(g) of
Landscape Code) .
sq.ft. % of site
~ Planning Dept. 10/82
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. IV. MISCELLANEOUS
The following materials must be-submitted in one (1) cOFY:
(check)
i. A check, payable to the City of Boynton Beach, as per the
attached fee schedule.
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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 (l) hour period, a traffic
irL,~~ct .u&1~1}"~i:; ~~:;t b~ =~!:=:. -ttcd. .
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
(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.
g~~J~~' .?-/I--~
Signature of Owner(s) or Trustee, Date
or Authorized Principal if property
is owned by a corporation or other
business entity.
VI.
AUTHORIZATION OF AGENT
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Signature Of-Auth -'zed
Agent
7--1-10
Date
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(I) (We) hereby designate the above signed person as (my)
(our) authorized agent in regard to this application.
~~~~~ 7--II-to
Signature of Owner(s) or Trustee, Date
or Authorized Principal if property'
is owned by a corporation or other
business entity.
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SPACE BELOW THIS LINE FOR OFFICE USE ONLY
Review Schedule:
Date Received:
Technical Review Board
Planning & Zoning Board
Community Appearance Board
City Council
Stipulations of Final Approval:
Date
Date
Date
Date
Other Government Agencies/Persons to be contacted:
Additional Remarks:
Planning Dept.--'lO/82
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