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. Incomplete
applications will not be processed.
Please print legibly or type all information.
I. GENERAL INFORMATION
1. Project Name: T/2AC., 'QJI
iltJIND,C:l0e A-r 1-!-{.-JIJTe3;"R.::5 RUN
111/ A-L.Lt::; D Gt1l2.1)r:::tuS:: - U (() I 7:5 /4-, ( t<:? r 4-0. ~ ~
,
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):
J./r.JI.)-rrstL'C tZo N (;("JA.JSTI2 ()OT'C)~V Go
Address:
I
.5 t:Ju T1/ p(r.) t::?~, -T'
) ,/,. ,I,) i~':".:r
l...",. ;,.../1', _._
Phone:
80-/1\)7(:'1..) 8G:;-GC-;l-/, t==L. 3?~' 4-;:;\?J
,
7E (9- 4 ~9co
4. Agent's Name (person, if any, representing applicant):
Address:
cIlA.,R.G55 N. GILBc.5-'r/2-r
I ~Or..(7)J.POIZ T L..d I'Ve
80YAJrOAJ 1i3e::~C.fJI FL. 3343 t;
73 B- 4 ':')96
Phone:
5. Property OWner's (or Trustee's) Name:
Phone:
5cJNHIT A:>Sc)c/.IJ TG5
.3700 CLU8HCJUs'G' L~ 100
/2;OYItJ rC)AJ Be-ACid, PL, 3343 b
7.34- bCJorJ
Address:
6. Correspondence address (if different than applicant or
agent)*:
* This is the address to which all agendas,
letters, and other material~ .~, be mailed.
Planning Dept. 1/89
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Page 2
7. What is applicant's interest in the premises affected?
(Owner, buyer, lessee, builder, developer, contract
purchaser, etc.)
DGVGt...~P&JZ
8. Street address or location of site:
/4. /6 (4-6(4~ W//LJD...5CJfZ L.LJtuB
9. Legal description of site and property control i:
'-'7""'.J "~ II
r /<.G C T c.~' A- -r ).JI..) AJ -rF5'O...s R. L) A)
10.
Intended use(s) of site:
;::? es / D!!3r I~.,) ...,... (A l~
11.
II-t uiUT6/2S /2VItJ
Developer or builder:
12.
Co IJ~T/2VC7 /o^-) c::= CJ
CJ.l-A~,-5S:: /V, ~/L8l:T/2T
Architect:
13. Landscape Architect: J3luJl>'::.:::.I...I./J W. ("'~ ILL, ~ R./~Tce ~ .6:$'SC.lC ,
14. Site Planner:
15. Engineer:
16.
Surveyor:
-
17.
Traffic Engineer:
18.
Has a site plan been previously approved by the City
Commission for this property? ~~~
19.
Estimated constructiop costs of proposed improvements shown
on this site plan: $ 1<:6 C? 0
Planning Dept. 1/89
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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
v
(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.
Signature o~~) or Trustee,
or Authorized Principal if property
is owned by a corporation or other
business entity.
:t IVf"
ate
(
(CI/t ;;/9 ()
, Date
VI.
(I) (We) hereby designate the above signed person as (my) (ou
r)
v
authorized agent in regard to this application.
d/tLi
Signature of Owner(s) or Trustee,
or Authorized Principal if property
is owned by a corporation or other
business entity.
{ /Jt)fo
. Oate
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:
1
Additional Remarks:
Planning Dept 1/89