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APPLICATION SITE PLAN APPROVAL APPLICATION 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. Incomplete applications will not be processed. Please print legibly or type all information. I. GENERAL INFORMATION 1. Project Name: J I IF 1"(0. feJ'~~( (] 0 y /'{ /0 /'( IJ e C?' ( f.,.' 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): Phone: ~ c/ Y /Y 70/'{ M 1<- V.Cl &" ( ( OI-(J. IlIr /Yo /":-P6erClt' J-fu ,/ G!J V /Y 7C- ;y ;~ ~ q C h J ;~ I..? J 93 5-- I / ^lc-hQe( I)e(vc~ (L/tJ7) ?J1--1386'6 Address: 4. Agent's Name (person, if any, representing applicant): C-€oY-tre 0 QC//5 ~ //()O(sou<:h ),&. (::-RJrjro( !--Ievy / f] c))/ ;VTo /Y l? e'qc~/'/ ('::'-1 . 3? t;:I 5-' Vi) 7 (7jJ-- 6/ J"'Y ) Address: Phone: 5. Property OWner's (or Trustee's) Name: Address: /30 Y/t!;/Y Ale ho~( / . III c;- /ytJ. F.Rri Pfv::- / /So/y /71Z> /y f3pq ch / t.(tJ7 - 7 ]{(-tJ8 6' b (0 h fJ l-l~ Y ~I , .3.5 93 -5 - Phone: 6. Correspondence address (if different than applicant or agent)*: S IT fV1 -P * This is the address to which all agendas, letters, and other materials will be mailed. Planning Dept. 1/89 Page 2 7. What is applicant's interest in the premises affected? (Owner, buyer, lessee, builder, developer, contract purchaser, etc.) o 'tV /'( e ~ 8. Street address or location of site: 11/>- /Yo r:pcferq( 1-1-7' [30 y /y '7(; /'Y ,3 J2q.C: '-' ) F I, 33 9;1,- 9. Legal description of site and property control # :CJef-f.f-r5');)-:/ (/ 03-oo~t:> PrTflCilt 0 . 10. Intended use(s) of site: L 00 /'(8e 11. 12. 13. 14. 15. 16. 17. 18. 19. Developer or builder: OV ~e...,0- fV\lCh E>-el Oe{ veil Architect: {;-ecH-B e 0 qt/I 5 Landscape Architect: ~ Si te Planner: C eu r i .e 0 q (/[ J' f-t/R 5u I Tr/?r Engineer: /01 ~/;; Has a site plan been previously Commission for this property? Surveyor: B t1/ e /'-( Traffic Engineer: by the City Estimated construction on this site plan: approved Y~?5 / costs of pro~osed 5'~OOO.. ~ improvements shown Planning Dept. 1/89 Page 9 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 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 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. ~~.fi~!gcY:'~ (~~ /1~ .~. ~ 0/Vo . Si nature of Owner(s) or Trustee, or Author' ed Principal if property is owned y a corporation or other business entity. cA m7b~~ 1-. 7 / I P'B9 ( Da te VI. ~;)-J Ir/1 Date (I) (We) hereby designate the above signed person as (my) (ou r) authori~~d ~~ent iE7~e~to this application. n~-?q~/3 ,7 n . ) ~~ /-:- ':? . Sign ture of Owner(s) or Trustee, or Authorized Principal if property is owned by a corporation or other business entity. .m/~)~/?c5? ( Date SPACE BELOW THIS LINE FOR OFFICE USE ONLY Review Schedule: Date Received: Technical Review Board Planning & Zoning Board Community Appearance Board City Commission Date Date Date Date Stipulations of Final Approval: Other Government Agencies/Persons to be contacted: Additional Remarks: Planning Dept 1/89 r"'~-: ! , ! I I i I I - - - - - , c:s~__ ---.----4..____ II .~. .-1i ' '52' " p-",? ~,v~ 'I I I St70~ )~~ -~ :.-~-=-:---.:=:::--:~=:::-::::::~--~-_..- t-6f~- ,~~~~;-~C~-~=->-- T --I - 7Y~ -/ ---...-- . , --:::=-=:.::.::::..:.-.:.~~_. _:=::...:.___(Sr4n-Rci~o~ ! -----'='=-=ccc_=,- I I f I }!!r2 ~-4 1//4/<9 #a i --------- ------ -~--.----- ------------ \. 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