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APPLICATION APPLICATION ACCEPTANCE DATE: RECEIVED BY STAFF MEMBER- FEE PAID: RECEIPT NUMBER: CITY OF BOYNTON BEACH, FLORIDA PLANNING & ZONING DEPARTMENT SITE PLAN REVIEW APPLICATION FOR NEW SITE PLANS & MAJOR MODIFICATIONS TO EXISTING SITE Application Acceptance Date: Fee Paid: Receipt Number: This application must be filled out completely, accurately and submitted as an original to the Planning and Zoning Department. Twel ve complete, sequentially numbered and assembled sets of plans including a recent survey and appropriate fee shall be submitted with the application for the initial process of the Site Plan Review procedure. An incomplete submittal will not be processed. Please print legibly (in ink) or type all information. I. GENERAL INFORMATION 1. P roj e c t Name: J ~V It..a \J 1:4. ..t. ~1:::J2 k: 1I..1l~ lo'T fbfL LUEAJL ~~r l~ . 2. Applicant's name (person or business entity in whose name this application is made) : 12..o~~DM~ ~lO~ I Lua~ Wp-{ ,l~. t~'l") ~~ tt). ~tJtb\J ~ ~Y), ~uraJ ~'~ (Zip C~e) '7bt- ?"'-- '5~ Fax: ~l- ~9- ~167 Addres s : Phone: 3. Agent's Name (person, if any, representing applicant) : Address: (Zip Code) Phone: Fax: 4. Property Owner's (or Trustee's) Name: Address: Phone: ~~Co~l\~' ~ ~ J 4E!: ,.-. Fax: ~ (Zip Code) ',' 5. Correspondence to be mailed to agent only; if no agent~ then to applicant unless a substitute is specified below:* *This is the one address to which all agendas, letters and other materials will be mailed. 6. What is applicant's interest in the premises affected? ~wn~ buyer, lessee, builder, developer, contract purchaser, etc.) Ot.U~ 7 . Street address or location of site: ~bOvJ.~~ ~~ R- Of>- 4.7. ""~ . '1)'( - D\ -00'2 - 0'2.4C Lt> "i S 1..4- I '1.,,~ , 1.(p ~ ~1JlON ~iA~ PLAi ~ l,? l ~ %.>"L 8 . Property Control #: Legal description of site: 9. Intended use(s) of site: GoM~l- fr2..L JJ't\ J..I, bJI \\JlSt,S 10. Developer or Builder: ~ 6\OM.e~ 12. Architect: ~ C. ~S Landscape Architect: ~~ Site Planner: N"OtJe b ~e ~11...a: T\S-r=.t.E. ~ ~SOCtA~ Engineer: 4r~ t)tA.\~: b1-. ~\ZTotJ $~-r~ Surveyor: J~'" .L-. ~E{?~D ci 1\ss~"Tes, hJ~. 11. 13. 14. 15. Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD 16. Traffic Engineer: ~D~ 17. Has a site plan been previously approved by the City Commission for this property? -r~~ 18. Estimated construction costs of proposed improvements shown on this site plan: "l~ I ~OO . 00 II. SITE DATA The following information must be filled out below and must appear~ where applicable, on all copies of the site plan. (~G) 1. Land Use Category shown in the Comprehensive Plan LocA.L. ~~WL ~t..l&..U . G..... 2. 3. Zoning District +Je-t'~~Dt C.1, t!?/~L~ sq. ft. t~.1SJO Area of Site acre~ 4. Land Use -- Acreage Breakdown b. c. d. e. g. h. i. a. Residential, including surrounding lot area of grounds % of site acres Recreation Areas * (excluding water area) % of site acres Water Area % of site acres Commercial (!) · ~\4~ I tP c:> acre~ % of site f. Industrial 1 acres % of site Public/Institutional acres % of site Public, Private and Canal rights-of-way acres % of site Other ( specify) acres % of site Other (specify) acres % of site ,j Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD 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 Ground floor building tb # c;d::;~cre~ area ("building footprint") a. o , r?1 9 % of site b. Water area o acres o % of site c. Other impervious areas, including paved area of public & private streets, paved area of parking lots & driveways (excluding 1044-~ ~I landscaped areas), and -~ sidewalks, patios, decks, 1 and athletic courts. O. l"l acre~ d. Total impervious area 0 ,~oS- acre1 'Z.~~rr 'ley e. Landscaped area 0 . (!)lo acrej inside of parking lots (20 sq. ft. per interior parking space required - see Sec. 7.5-35(g) of Landscape Code) . (9,5l4-1 % of site O."~l' % of site O'~ % of site f. Other landscaped areas, () acres C) % of site g. Other pervious areas, including golf course, natural areas, yards, and swales, but excluding water areas () acres (9 % of site h. Total pervious areas o · orovc acreJ o I 3l~ acrel 0,7,.0 % of site i. Total area of site l&>o % of site 6. Floor Area Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD g. Other (specify, o sq. ft. h. ~sq. ft. Total floor area 7. Number of Residential Dwelling Units b. c. (1 ) (2 ) (3 ) ( 4 ) d. e. a. Single-family detached ~ sq. ft. Duplex sq. ft. Multi-Family (3 + attached Efficiency 1 Bedroom 2 Bedroom '3+ Bedroom -,welling uni ts) dwelling units dwelling units dwelling units dwelling units Total multi-family dwelling units Total number of dwelling units Nbr Gross Density N~ dwelling units per acre Maximum height of structures on site 1h feet 1- stories 8. 9. 10. Required off-street parkinq a. Calculation of required number of off-street parking spaces b. Off-street parking spaces provided on site plan ?~~ ~ l?~ l?~ Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\F.ORMS\APPS\NWSP\sITEPLAN.WPD 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 plans, specifications, drawings, engineering and other data which may be approved by the City of Boynton Beach, or its boards, commissions, staff or designees 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 grante? The applicant agrees to allow the City of Boynton Beach all rights and remedies as provided for by the applicable codes and ordinances of the City of Boynton Beach to bring any violation into compliance, and the applicant shall indemnify, reimburse and save the City of Boynton Beach harmless from any cost, expense, claim, liability or any action which may arise due to their enfor ement of the same. AND AGREED TO , 19 this ~'fL., day of (ielgv~ {- (err 1 y//Yl2t&/~ Applicant ~, l~ ~t.?~ / Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD III. CERTIFICATION (I) ~ understand that this application and all papers and plans submitted herewith become a part of the permanent records of the Planning and Zoning Department (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 ~s~accord::g the instructions below. Signature of Owner(s) or Trustee, of Authorized Principal if property is owned by a corporation or other business entity. ~~ Date (771 IV. AUTHORIZATION OF AGENT Signature of Authorized Agent Date (I) (We) hereby designate the above signed person as (my) (our) authorized agent in regard to this application. Signature of Owner(s) or Trustee, or Authorized Principal if property is owned by a corporation or other business entity. Date SPACE BELOW THIS LINE FOR OFFICE USE ONLY Review Schedule: Date Received Technical Review Committee Planning & Development Board Community Appearance Board City Commission Date Date Date Date Stipulations of Final Approval: Other Government Agencies/Persons to be contacted: Additional Remarks: Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD APPLICATION ACCEPTANCE' nE: RECEIVED BY STAFF MEMBEh. FEE PAID: RECEIPT NUMBER: CITY OF BOYNTON BEACH, FLORIDA PLANNING & ZONING DEPARTMENT SITE PLAN REVIEW APPLICATION FOR NEW SITE PLANS & MAJOR MODIFICATIONS TO EXISTING SITE Application Acceptance Date: Fee Paid: Receipt Number: This application must be filled out completely, accurately and submitted as an original to the Planning and Zoning Department. Twelve complete, sequentially numbered and assembled sets of plans including a recent survey and appropriate fee shall be submitted with the application for the initial process of the Site Plan Review procedure. An incomplete submittal will not be processed. Please print legibly (in ink) or type all information. I. GENERAL INFORMATION 1. Pro j e c t Name: J ~V l L.O. \J 4 ..t. ~ I:::J2 k:.J a.Jk lo'T fbrz- Lt..EA-e.- ~ P"( r l ~ . 2. Applicant's name (person or business entity in whose name this application is made) : 12..o~1..-FeLoM~ ~lO~ I ~~ WPi ,l~. ~'l") b~ tt). ~tJtb\J ~ ~Y), ~uraJ ~ ~ \ (Zip Cu'C1e) '7bt- ?"''''- '5~ Fax: Sbl- ~9 - ~167 Address: Phone: 3. Agent's Name (person, if any, representing applicant): Address: (Zip Code) Phone: Fax: 4. Property Owner's (or Trustee's) Name: Address: Phone: ~~ LD\.?i I \~. ~ ~-Mf!: (Zip Code) Fax: $~ 5. Correspondence to be mailed to agent only; if no agent~ then to applicant unless a substitute is specified below:* *This is the one address to which all agendas, letters and other materials will be mailed. 6. What is applicant's interest in the premises affected? ~w~ buyer, lessee, builder, developer, contract purchaser, etc.) ot.U~ 7. Street address or location of site: ~foOvJ.~~ ~ R- 8. Property Control #: Of>- A.?- ""~ . '1}'( - D\ -00'2.. - 0'2.4C , Lt> "is 1..4-,1.,,~, 1(p ~e... ~1JtON ~iA~ PLAt ~ l'? l ~ %.>"L Legal description of site: 9. Intended use(s) of site: GoM~L- fruJJ't\u., ~\~~ 10. Developer or Builder: ..... &lA2o 6\oM.e ~ 13. Architect: ~ C. ~S Landscape Architect: ~~ Si te Planner: N" O~ ~e ~.tl...a: T\S-GUL f- ~SOCtA~ Engineer: ~~ t)tA.\~.# ~. ~\ZTotJ $tutl-r~ Surveyor: -(2..~'" .\.-. ~Ef>~D ci ~s~'Tes, hJ~. 11. 12. 14. 15. Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD 16. Traffic Engineer: ~D~ 17. Has a site plan been previously approved by the City Commission for this property? -r~~ 18. Estimated construction costs of proposed improvements shown on this si te plan: t>l~ I ~no . 00 II. SITE DATA The following information must be filled out below and must appear~ where applicable, on all copies of the site plan. (~G) 1. Land Use Category shown in the Comprehensive Plan LocA.L.~~WL ~t..l~ -GLAc 2 . Zoning District +JBt,fkf;>~\? t G. 'L. l1? I ~ LV:; sq. ft. 3 . 1~.1SJO Area of Site acre~ 4. Land Use -- Acreage Breakdown a. b. c. d. e. g. h. Residential, including surrounding lot area of grounds % of site acres Recreation Areas * (excluding water area) % of site acres Water Area % of site acres Commercial (J> · ~\4~ I tPC:> acre~ % of site f. Industrial acres 9- of site 0 Public/Institutional acres % of site Public, Private and Canal rights-of-way acres 9- of site 0 Other (speci fy) acres % of site Other ( specify) acres 9- of site 0 i. Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN,WPD 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 Ground floor building (t;) # C7d-1~cre~ area ("building footprint") a. b. o acres Water area c. Other impervious areas, including paved area of public & private streets, paved area of parking lots & driveways (excluding 1044-~ ~I landscaped areas), and -~ sidewalks, patios, decks, 1 and athletic courts. O. l"l acre~ d. Total impervious area {) ,1,0<7 acre1 ~'l4o~ rr 'ley e. Landscaped area () . Db acrej inside of parking lots (20 sq. ft. per interior parking space required - see Sec. 7.5-35(g) of Landscape Code) . o , r,,1 9 % of site o % of site (9., S l4-\ % of site o . ~~ l~ 9- of site 0 o'~ % of site e o O,'},L/ l~o f. Other landscaped areas, o acres % of site g. Other pervious areas, including golf course, natural areas, yards, and swales, but excluding water areas () acres % of site % of site % of site a. Residential ~ sq. ft. b. Commercial/Office ~sq. ft. lst Fin , (21tr!'~ pt., 14 r~ c. Industrial/Warehou~~ ~y. ft. d. Recreational +Sq. ft. Public/Institutional ft. e. +sq. f. Other ( specify) sq. ft. Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN.WPD g. h. Other (specify) 6/ sq. ft. Total floor area ~3D sq. ft. 7. Number of Residential DwellinQ Units a. b. c. (1 ) (2 ) (3 ) (4 ) d. e. Single-family detached sq. ft. Duplex sq. ft. (3 + attached ~welling units) dwelling units dwelling units dwelling units dwelling units Multi-Family Efficiency 1 Bedroom 2 Bedroom '3+ Bedroom Total multi-family dwelling units Total number of dwelling units N~ N~ 8 . Gross Density 't.. stories dwelling units per acre 1h 9. Maximum height of structures on site feet 10. ReQuired off-street parking a. Calculation of required number of off-street parking spaces Off-street parking spaces provided on site plan b. ?~~ ~ t?~ l?~ Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\F.ORMS\APPS\NWSP\SITEPLAN.WPD 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 plans, specifications, drawings, engineering and other data which may be approved by the City of Boynton Beach, or its boards, commissions, staff or designees 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 agrees to allow the City of Boynton Beach all rights and remedies as provided for by the applicable codes and ordinances of the City of Boynton Beach to bring any violation into compliance, and the applicant shall indemnify, reimburse and save the City of Boynton Beach harmless from any cost, expense, claim, liability or any action which may arise due to their enfor ement of the same. #~-~, AND AGREED TO , 19 this fJd'f1-. day of algvr; {- /t:f11 vm~ Applicant t/ Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN .WPD III. CERTIFICATION (I) ~ understand that this applicatiQn and all papers and plans submitted herewith become a part of the permanent records of the Planning and Zoning Department (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 -,s~COrding the instructions below. Signature of Owner(s) or Trustee, of Authorized Principal if property is owned by a corporation or other business entity. ~dT) Date (111 IV. AUTHORIZATION OF AGENT Signature of Authorized Agent Date (I) (We) hereby designate the above signed person as (my) (our) authorized agent in regard to this application. Signature of Owner(s) or Trustee, or Authorized Principal if property is owned by a corporation or other business entity. Date SPACE BELOW THIS LINE FOR OFFICE USE ONLY Review Schedule: Date Received Technical Review Committee Planning & Development Board Community Appearance Board City Commission Date Date Date Date Stipulations of Final Approval: Other Government Agencies/Persons to be contacted: Additional Remarks: Planning and Zoning Department - Rev. 3/18/97 S:\PLANNING\SHARED\WP\FORMS\APPS\NWSP\SITEPLAN,WPD