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APPLICATION . . /' . T" /" ~:; / .. . qJ (). 'if b ~ . . SITE PLAN ~PPROV~L ~PPLIC~TION City of Boynton Beach, Florida Planning and zoning Board This application must be filled out completely and accurately and submitted in one (1) copy to the Planning Department. Incompl~te applications will not pe processed. Please print legibly or type all information. I. GENERAL INFORMATION 1. Project Name:))R... Bou RC)u e.. yy\ I h , 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): ~oB-e~+ G- bOoK.Qu-e.. n1, 1), Address: fl.:fJ J.J <.0 I "3 $.,- S v t.f. e <f- c..:, OOCA 1(t\-4-0k) ,.f L ~3l.fgC:, , Phone: 3Cf""2.. - L{O/<I 4. Agent's Name (person, if any, representing applicant): b?C.cG.-l+ :rth8CE s,~;.,s ,TtJC- 01 Address: ~7~ ~E. 3~O ~-t- De Lftfh1 'B c k F L 3:" '/-V 'f j Phone: ;)1 g-7y Jt! 5. Property Owner's (or Trustee's) Name: ~ftMe AS #3 Address: 6. Phone: Correspondence address (if different than applicant or a~~!l.!: ) * : .~ .,... >-. ....-. -.'"....-- . , , I I I I ". * This is the address to which all agendas, letters, and other materials will be mailed. Planning Dept. 1/89 " . " , qf~9f '\ .,/. / " .. .-, ,.. Page 2 7. What is applicant's interest in the premises affected? (Owner, buyer, lessee, builder, developer, contract purchaser, etc.) O~N c:it. . I ~ : 8. street address or location of site: /0/ . S6 I :2 7 ctve. 9. Legal description of site and property control #: Lof / (;/iy IJ1d~ I ~s-l /J-I E5 c-/ 10. Intended use(s) of site: t/~~/C~ ~/~~ 11. Developer or builder: 12. Architect: 13. Landscape Architect: - 14. Site Planner: 15. Engineer: 16. Survey~r: 17. Traffic Engineer: 18. Has a site plan been previously approved by the City Commission for this property? .I'~~ I Estimated construction costs of proposed improvements shown on this site plan: 3S"00, 00 19. , I .~. I / I .,.,-.-. _c. '_. .-- ~-- I ! Planning Dept. 1/89 / I , I i .1 / i / / ::D^'o ~ ~ -{;L1t ^(y. Page 9 IV. MISCELLANEOUS (check) The following materials must be submitted in one (1) copy: 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) i hour period, a traffic impact analysis must be submitted . 3. 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 I 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 s ructions low. r . . <otf~~/ " ~ 8..Z5" "6i'J Date . Agent the above signed person as (my) (ou this apPliCatiO~ '0 Trustee, : ~~~ ~ or Authorized Principa if property . is owned by a corporation or other . business entity. 'SPACE BELOW THIS-LINE FOR OFFICE USE ONLY r) I / Review-Schedule: --. Date Received: Technical Review Board 'Planning & Zoning Board Community Appearance Board City Commission StipUlations of Final Approval: Date Date. Date Date ; Other Government Agencies/Persons to be contacted: Additional Remarks: I .. I '. Planning Dept 1/89