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APPLICATION CITY OF BOYNTON BEACH, FLORIDA PLANNING & ZONING BOARD LAND USE AMENDMENT AND/OR REZONING APPLICATION This application must be filled out completely and accurately and submitted, together with the materials listed in Section II below, in two (2) copies to the Planning Department. Incomplete applications will not be processed. Please Print Legibly or Type All Information. I. GENERAL INFORMATION 1. Project Name: ~k(f2ENCZ;: CA~S - AP? ~L/ . AI'V/Vckl'(r/c:J/y 'PR..o<5J?A,/Yf 2 . Type of Application (check one) ? r-/A SF ,; - 6/2. G' L) P 0<. a. Rezoning only b. Land Use Amendment Only )( c. Land Use Amendment and Rezoning 3. Date this application is accepted (to be filled out by Planning Department): IVuVEMlsE;<:;.-:> ~/ t95'Ll 4. Applicant's Name (person or business entity in whose name this application is made): Address: Uf~.f;eENcEC)Af{s - GI2(CJL_~ IN~. to t./FL.-I IIomE5 - (Zip Code) Phone: FAX: 5. Agent's Name (person, if any, representing applicant): CI/.Y uF 'AG,,4TO/ll l5EACf( Address: (Zip Code) Phone: FAX: 6. Property Owner's (or Trustee's) Name: Address: (Zip Code) FAX: PLANNING DEPARTMENT - APRIL 1991 A: LandUse ( 2 ) 7. Correspondence Address (if different than applicant or agent) : *This is the address to which all agendas, letters, and other materials will be mailed. 8. What is the applicant's interest in the subject parcel: (Owner, Buyer, Lessee, Builder, Developer, Contract Purchaser, etc.) oWNER 9. Street Address or Location of Subject Parcel: )(c,R-rHkI'E:51 CGI2NEK OF LA (II-! RFN~E k'D" AN'D i:! NoLL wooo A2p- 10. Legal Description of Subject Parcel: ~~~ /\ // rtC f/ ;vr rNT 11. Area of Subject Parcel (to the nearest hundredth (1/100) of an acre): C{:< ACRES 12. Current Zoning District: K S - S E 13. Proposed Zoning District: ~L\~ 14. Current Land Use Category: I'<rEtJ..T6!/? RI:S. 0- 15. Proposed Land Use Category: (..c:.::>(.r.tPEA/SITy RES~ 16. Intended Use of Subject Parcel: 'R SINGLE F /( f77 / / Y :< T,,:: I D r;: Nr / A C ( 17. Developer or Builder: l)2 Io!.f: /-k.c;)l'T E5 I {nU~U /KJW7E5 18. Architect: 19. Landscape Architect: 20. Site Planner: 21. Civil Engineer: 22. Traffic Engineer: 23. Surveyor: PLANNING DEPARTMENT - APRIL 1991 A: LandUse (7) III. APPLICATION FEES. Fees shall be paid at the time that the application is submitted, according to the fees which have been adopted by ordinance or resolution. The Planning Department will inform the applicant as to the fees which are required. All fees shall be paid by check, payable to the City of Boynton Beach. IV. CERTIFICATION , (I) (We) understand that this application and all plans and papers 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. ,4/ViY5^ ff7/CJN ?Rc. G RA rrr sre &fItTERSEKV/CE' A6REE~--rF/VT Signature of Owner(s) or Trustee, Date or Authorized Principal if property is owned by a corporation or other business entity. V. AUTHORIZATION OF AGENT I Signature of Authorized Agent Date (I) (We) hereby designate the above signed person as (my) (our) authorized agent with 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. PLANNING DEPARTMENT - APRIL 1991 A:LandUse