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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 FBtlU e ~fV /..07 ./..11V6 {II )J f !o Tit Ave ~tAe- 1. Project Name: 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) : ,r) WR If\( A~~f?.R!<.O -{;3:z. !l/.J..E.AI RUe D Ghl? R v IS b/l<!-fI p~, -!3 ,/g--~ I / ;}. 7i'- d.70 7 Address: Phone: 4. Agent's Name (person, if any, representing applicant): Address: Phone: 5. Property Owner's (or Trustee's) Name: DC~jf1- IN n6r?.R./lffD ~ Address: ~ .J 2- flhLbN fi v& /J G I- Aft y P 61J(~j( .3.?~ 3 , I Phone: ;2,?~ - 2-.70 ;7 \ 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. 10/82 rage 2 7. What'is applicant's interest in the premises affected? (3 LV AI 6 (.( (Owner, Buyer, ~essee, Builder, Developer, Contract Purchaser, etc.) 8. street Address or Location of Site: (oIl /V,e, /~~__B'{/C 9. Legal Description frUl L S L PI( IE. of Site/Property Control #: Cl r J.. () TL---L.J;-~~ ~/ 'Y-~'; /::;'IJP II--'J)~;'; l3~tJ~.I( O{/ 10. Intended Use (s) of Site: {fPflR1f'18N-r , I 11. Developer or Builder. a; W 11( 61< 12. Architect: 13. Landscape Architect: 14. Site Planner: 15. Engineer: 16. Surveyor: 17. Traffic Engineer: 18. Has for a site plan been previously approved by the City Council this property? _~____________ _ _____u ._----~-_._._~._~_.__.- Lhis site construct~ cost of plan: SClO'-!!....Ci propo~:(,tl imprOVeril12rlts sholvn on 19. Estimated //,f fr[eR ,,./- Planning Dept. 10/82 II. SITE DATA Page 3 The following information must be filled out below and must appear, where applicable, on all six (6) copies of the site plan. 1. Land Use Cateqory shown in the Comprehensive Plan 2. Zoning District ^ / 3. Area of Site acres sq. ft. 4. Land Use -- Acreage Breakdown a. Resid~tial, including surro~~~ing lot area or grounds \ ... "\ \ b. Recreation\Areas * (excluding wpter area) , c. Water Area d. Commercial e. Industrial f. Public/In- stitutional g. Public,private, Rights-of-Way h. Other (specify) i. Other (specify) " j. Total Area of Site * Including open s having a minimu 5. Surface Cover a. Ground Floor BU~ding Area ("building, footprint") b. Water Area c. Other Impervious Areas, including paved area of public & private streets, paved area of parking lots & driveways (ex- cluding' landscaped areas) , and sidewalks, patios, decks, and athletic courts. . / ; % of site acres % of site acres .% of site acres % of site acres % of site acres % of site acres % of site acres % of site acres % of site 100 % of site for outdoor recreation, and o ft. by 50 ft. % of site % of site sq. ft. % of site sq.ft. % of site , sq.ft. % of site d. Total Impervious Area e. Landscaped Area Inside of Parking Lots (20 sq.ft. per interior parking space required-- see Sec. 7.5-35(g) of Landscape Code) . PI~nninN n~~t. In/R2 Planning Dept. 10/82 Page 4 f. Other Landscaped Areas, excluding Water Area sq.ft. '% of site g. Other Pervious Areas, including Golf Courses, Natural Areas, Yards, and Swales, but excluding Water Areas t ! sq.!t. sq;: ft. ;;q.ft. % of site h. Total Pervious Areas % of site i. Total Area of Site 100 % of site a. ! ! / sq. ft. ! ! sq.ft. sq. ft. sq.ft. 6. Floor Ar a b. c. d. Recreational e. Publici Institutional ! I sq. ft. sq.ft. f. Other (specify) , , , , , I , g. Other (specify) sq.ft. h. Total Floor Area sq.ft. 7. Number of Residential Units a. Single-Family dwelling units b. Duplex dwelling units c. Multi-Family (3 + attached dwelling (1) Efficiency dwelling units (2) 1 Bedroom dwelling units (3) 2 Bedroom dwelling units (4) 3+ Bedroom dwelling units , d. Total Multi-Family dwelling units e. Total Number of Dwelling Units 8. Gross Density Dwelling Units per Acre 9. Maximum Height of Structures on Site 10. Required Off-Street Parking feet stories a. Calculation of Required Number of Off-Street Parking Spaces b. Off-Street Parking Spaces Provided on Site Plan Planning Dept. 10/82 IV.' MISCELLANEOUS Page 9 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 . - ..).. _. _, "-_!... _.._-1.. \.".... ....~1-.._~ ...........,..::1 ..........t"".........l",. ""'...u........r............ ................ ;"J,,- ....................._............. 3. Any other engineering and/or technical data, as may be re- quired 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 is application will not be accepted un s signed acco in to the i structions below. " 8-<~~P~ / D te / ignature of Owner(s) or Trustee, or Authorized Principal if property is owned by a corporation or other business entity. VI. 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. Date " Signature of Owner(s) or Trustee, or Authorized 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 Council Stipulations of Final Approval: Date Date Date Date Other Government Agencies/Persons to be contacted: Additional Remarks: Planning Dept. 10/82