APPLICATION
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SITE PLAN APPROVAL APPLICATION
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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 (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: BOURQUE & DAWSEY M.D. P.A.
101 South East ~7th. Ave.
BOYNTON BEACH, FLORIDA
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):
BOURQUE & DAWSEY M.D. P.A.
Address:
951 N.W. 13th. ST.
BOCA RATON, FLORIDA 33432
Phone:
392-4015
4. Agent1s Name (person, if any, representing applicant):
ALVARO VERA (BLAIR CONSTRUCTION CO., INC.)
Address:
238 S. E. 2ND. AVE.
DELRAY BEACH, FLORIDA
.
Phone:
276-7913
5. Property OWner's (or Trustee's) Name:
BOURQUE & DAWSEY
951 N.W. 13th. ST.
Address:
Boca Raton, Florida
Phone:
392-4015
6. Correspondence address (if different than applicant or
agent)*:
* This is the address to which all agendas,
letters, and other materials will be mailed.
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7.
What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, developer, contract
purchaser, etc.)
BUILDER
8. street address or location of site:
101 S.E. 27th. Ave. Boynton Beach, Fl.
9. Legal description of site and property control #:
Lot 1 of GAY MAR ESTATES, according to the Plat, thereof recorded
~n Piat ~00k-~4, at page ilU OI the Pubi~c Records ot Paim Beach
County, Florida;
LE~~: A parcei OI land Ior R.O.~. purposes iy~ng ~n the S.W.~
of Section 33 Township 33S, Range 43E. P.B.C..
10. Intended use(s) of site: Doctor's Office
11.
Developer or builder:
BLAIR CONSTRUCTION CO., INC.
Architect:
Ronal H. Miller
12.
13.
14.
15.
16.
Landscape Architect:
Do.
site Planner:
Do.
Engineer:
E
Surveyor:
Paramount Engineering
O'Brien Suiter & O'Brien/Paramount Eng.
17. Traffic Engineer:
18. Has a site plan been previously approved by the City
Commission for this property? Yes.
19. Estimated construction costs of proposed improvements shown
on this site plan: REVISION FOR NEW DOOR ($ 225.00)
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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.
1. Land Use Category shown in
the Comprehensive Plan
2. Zoning District
3.
Area of Site
acres
sq. ft.
4. Land Use -- Acreaqe Breakdown
a. Residential, including
surrounding lot area or
grounds
% of site
acres
...
b. Recreation Areas *
(excluding water area)
d. Commercial
acres % of site
acres % of site
acres % of site
acres % of site
acres % of site
acres % of site
acres % of site
c. Water Area
e. Industrial
f. Public/Institutional
g. Public, private and
Canal rights-of-way
h. Other (specify)
i. Other (specify)
acres
% of site
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j. Total area of site
acres
% of site
* Including open space suitable for outdoor recreation,
and having a minimum dimension of 50 ft. by 50 ft.
5. Surface Cover
a. Ground floor building sq.ft.
area ("building footprint")
% of site
b. Water 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.
% of site
d. Total impervious area sq.ft.
% of site
e. Landscaped area sq.ft.
inside of parking lots
(20 sq. ft. per interior
parking space required-
see Sec. 7.5-35(g) of
Landscape Code).
% of site
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f. Other landscaped areas, sq. ft. % of site
excluding water area
g. Other pervious areas,
including golf courses,
natural areas, yards, and
swales, but excluding
water areas sq. ft. % of site
h. Total pervious areas sq. ft. % of site
i. Total area of site sq. ft. % of site
6. Floor Area
a. Residential sq. ft.
b. Commercial/Office sq. ft.
c. Industrial/Warehouse sq. ft.
d. Recreational sq. ft.
e. Public/Institutional sq. ft.
f. Other (specify) sq. ft.
g. Other (specify)
sq. ft.
h. Total floor area sq. ft.
7. Number of Residential Dwelling Units
a. Single-family detached dwelling units
b. Duplex dwelling units
c. Multi-Family (3 +
attached dwelling units)
(1) Efficiency dwelling units
(2) 1 Bedroom dwelling units
( 3 ) 2 Bedroom dwelling units
( 4 ) 3+ Bedroom dwelling units
d. Total multi-family dwelling units
e. Total number of dwelling units
8.
Gross Density
dwelling units per acre
9.
Maximum height of structures on site
feet
stories
10. Required off-street parking
a. Calculation of required
number of off-street
parking spaces
b. Off-street parking spaces
provided on site plan
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IV.
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MISCELLANEOUS
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)
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 pro~isions of the City's Code of
Ordinances.
V. CERTIFICATION
VI.
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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 ins u . ns below.
skflFJ
Date
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Date
above signed person as (my) (ou
this apPliCatiOn.~ .!
b {)-r fr;.
or Trustee, Date
or other
SPACE BELOW THIS LINE FOR OFFICE USE ONLY
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:
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