APPLICATION
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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. Incompl~te
applications will not pe processed.
Please print legibly or type all information.
I. GENERAL INFORMATION
1. Project Name: ~ L ~\ SJ4.-l L'C- C/~(l- u..JA....(r{
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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
this application is/mad. e): .
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in whose name
Address:
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Phone:
4.
Agent's Name (person, if any, representing applicant):
Address:
Phone:
Property Owner's (or Trustee's) Name:
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Address:
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Phone:
6.
Correspondence address (if different than applicant or
agent)*:
* This is the address to which all agendas,
letters, and other materials will be mailed.
Planning Dept. 1/89
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7.
What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, developer, contract
purchaser, etc.)
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Street address or location of site:
9.
Legal description of site and property control #:
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10.
Intended use(s) of site:
~ 1.1 /2 I-L l.tf I-l. {ExIST! LI0 ~
11. Developer or builder:
12. Architect:
13. Landscape Architect:
14. Site Planner:
15. Engineer:
16. Surveyor:
17. Traffic Engineer:
18. Has a site plan been previously approved by the City
conunission for this property? .lYCJ i
19. Estimated construction costs of ~roposed improvements shown
on this site plan: "'~OC"> r',r"'J
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Planning Dept. 1/89
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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
the attached fee schedule.
I
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'
I
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 ot
showings in any papers or plans submitted herewith ,are true
to the best of (my) (our) knowledge and belief. This
applic on will not be accepted unless signed according to
,,/ the . suctiofJ' b"
^ " ( Z5~rP'> /;z./lfJ
Signatur. of Owner(s) or Trustee, Date
or Auth rized Principal if property
is owned by a corporation or other
business entity.
VI.
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Date
(I) (We) hereby designate the above signed person as (my) (ou
X 2iZd rn&e:~ this ap~lica~i:ZII jerl
Signat re of Owner(s) or Trustee, Date
or Aut orized Principal if property
is owned by a corporation or other
business entity.
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:
Planning Dept 1/89
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