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HomeMy WebLinkAbout2011-003 PUD Amendment 4� X BROOKL f�'t Planning Commission Application Dt Receiu F/V 'TER Please Print Clearly or Type ApphcattQno +� + Address /Street Location of Property Br ool Occle- Legal Description of property "See Attached" A preliminary meeting with the Planning Staff is required prior to the submission a Planning Commission application. No application will be accepted prior to such meeting. Applicant Information: Owner Information: Name Loren Van Der Slik Name Loren Van Der Slik Address 101 South Main St., Dickson, TN Address 101 South Main St., Dickson, TN Phone (615) 446 -7109 Fax (615)446-7105 Phone (615) 446 -7109 F ax (615)446-7105 Email Email Type of Request: F7 Rezoning ($1050) ❑ Special Use Permit ($200) ❑ Subdivision Approval ($300) F-1 Site & Building Plan Approval ($750) ❑ Planned Unit Development ($1800) ❑ Appeal ($200) Variance ($200) F Other: Description of Request: Amending the existing Planned Unit Development. O tP Application Fee $ 9 0 0 / 60 Acct No. 10100. -4403 Receipt No. J The applicant requests processing of this application and agrees to pay to the City of Brooklyn Center, within fifteen (15) days after mailing or delivery of the billing statement, the actual costs incurred by the City for Engineering, Planning and Legal expenses reasonably and necessarily required by the City for the processing of the application. Such costs will be in addition to the application fee described herein. Withdrawal of the application will not relieve the applicant of the obligation to pay costs incurred prior to with awal. From k Ga-H 'n Applicant (Please Print) Applicant's Signature Page 1 City of Brooklyn Center - Business and Development - 6301 Shingle Creek Pkwy - Brooklyn Center MN 55430 763- 569 -3300 Planning Commission Application Form 10 -10 City Use Only City Use Only Ci Use'O)TO Planning Commission Recommendation Dates of PC Legal Notice Notices Mailed Action Taken Approved Consideration Published Resolution No. 7 =—— ( D ePUOrtkm 01 D 3 - 10 -1 "1• Fw" rc,bte Zon -62- Approved ❑ Denied this X day of /�t/`G� 20 subject to the following conditions: Chairman City Council Action Dates of Council Legal Notice Notices Mailed Action Taken Approved Performance Consideration Published Resolution No. Bond Received ❑ Approved ❑ Denied this 3 ) S� day of 20 I , with the following amendment: Q )t 0 K 11 14 73i l r i 4 Clerk/Planning Commission Secretary Page 2 City of Brooklyn Center - Business and Development - 6301 Shingle Creek Pkwy - Brooklyn Center MN 55430 763 - 569 -3300 Planning Commission Application Forth 10 -10