APPLICATION
CITY OF BOYNTON BEACH, FLORIDA
PLANNING & ZONING BOARD
SITE PLAN APPROVAL APPLICATION
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: _fcRt"::::>1U...- ccr HtJI\lTe12.S \~
( --th~ s "~-fO rT'I pe- V l q V II urU.J-s ~
(h~ l':-~ ~s act~uo(l w BrL-;;;;'ro I)
- 2. Date this application is accepted:
(to be filled out by Planning Department)
3. Applicant's name (person or business entity in whose
name this application is made):
~
~,(""l1.:3e.... GJ_'! ~~ .r ~::r)'E:vtlctrcn
Address:
Phone:
~;y(\bn 1~Ct.ch \ FL-
"7 2:4- 91' 0 FAX:
~34Z0
(Zip Code)
4.
Agent's Name (person, if any, representing applicant):
Phone:
.. ---- "
~ "c ~1e IlC--, IrfY)<--l7SC ill
0550 0. Co~less A:Jre '
LCUI+O..JlCt I i==L 32:>4<02-
9(09 - 5Z.911154~ l500t)AX:
I
Property Owner's (or Trustee's) Name :JT2..Ac:-T ltJtt
~lVL 6=>J
_I-\t..t.n tc-rs-B,..n
Address:
(Zip Code)
5.
Address:
~
(Zip Code)
FAX:
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"DEPARTMENT - January 1991
f} : Si tePlan
( 2 )
7. What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, 'developer, contract
purchaser, etc.) ~LLil~
8.
Street address or location of site:
~Lstbi
9. Legal description of site and property control #:
10. Intended use(s) of site: RC'.";"Jtc:lt.n1::1QJ hct')UL.-
11. Developer or builder: (3 ~ (lj .lluerho t~
12. Architect: \.A..)~/Y\iL. 3uotj-
,
13. Landscape Architect: ~J~
I
14. Site Planner:
N/A
/
15. Engineer: tv I~
t'
16. Surveyor: ~/~
/
17. Traffic Engineer:~/~
/
19.
Has a site plan been previously approved
Commission for this property? -.::f ~
Estimated constr~ton costs of proposed
this site plan: 4 000
t
by the City
18.
improvements shown on
PLANNING DEPARTMENT - January 1991
c:SitePlan
RIDER TO SITE PLAN APPLICATION
The undersigned as applicant for Final Site Plan Approval does
hereby acknowledge, represent and agree that all plans,
specifications, drawings, engineering, and other data
submitted with this application for review by the City of
Boynton Beach shall be reviewed by the various boards,
commissions, staff personnel and other parties designated,
appointed or employed by the City of 'Boynton Beach, and any
such party reviewing the same shall rely upon the accuracy
thereof, and any change in any item submitted shall be deemed
material and substantial.
The undersigned hereby agrees that all aspects of the proposed
project shall be constructed in strict compliance with the form in
which they are approved, and any change to the same shall be deemed
-material and shall place the applicant in violation of this
application and all approvals and permits which may be granted.
The applicant acknowledges that the City of Boynton has all rights
and remedies as provided by the applicable codes and ordinances of
the City of Boynton Beach to bring any violation into compliance,
and that in the event of enforcement action by the City, the
applicant shall indemnify, reimburse and save the City of Boynton
Beach harmless from any costs, expense, claim, liability or any
action which may arise due to their enforcement of the same.
READ, ACKNOWLEDGED AND AGREED TO THIS ~ DAY OF
-11;
, 199+-.
( 9 )
IV. MISCELLANEOUS
The following materials must be submitted in one (1) copy:
(check)
\../'
2.
A check, payable to the City of Boynton Beach, as per the
attached fee schedule. 1> ~.--
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.
1.
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
instructi~;1elow .
~~V\.+=1~~ "f~r ~~\4J~ S-/3/f/
Signature of Owne ) or Tr stee, Date
of Authorized Principal if property
is owned by a corporation or other
business entity.
VI. AUTHORIZATION OF AGENT
. ~~_. .
fl...t~'-~ 4...t...P..tA
Signature of Authorized Agent
:5/!V9/
Date
signed person as (my)
this application.
'14/~ J) 3/rr
Date'
SPACE BELOW THIS LINE FOR OFFICE USE ONLY
Review Schedule:
Date Received
Technical Review Board
Planning & Zoning Board
Community App~arance Board
City commission
Date
Date
Date
Date
Stipulations of Final Approval:
Other Government Agencies/Persons to be contacted:
Additional Remarks:
PLANNING DEPARTMENT - JANUARY 1991
C:SitePlan