HomeMy WebLinkAbout2011-004 Preliminary Plat �"sliy lrF$e ��� � } ���� 4�r,, ,A
c;rJ, Planning Commission Applieation Date:Re� l �d
I BROOKLYN
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1 �a. Print at o r Appl cai}oit =ITo'
Address /Street Location of Property * A x erxo8 Ave. North and Co unty Road 10, Brooklyn Center, MN
Legal Description of Property "See Attached"
A preliminary meeting with the Planning Staff is required prior to the submission.of a Planning
Commission application. No application will be accepted prior to such meeting.
Applicant Information: Owner Information:
Name Loren Van Der S1ik Name Loren Van Der Slik
Address 101 South Main. St., Dickson, T Address 101 South Main St., Dickson, TN
Phone (625)446 -7109 Fax (615)446 -7105 Phone (615) -7 109 F (615)446 -7105
Email Entail
Type of Request: El Rezoning ($1050) Special Use Permit ($200)
Subdivision Approval ($300) F-1 Site & Building Plan Approval ($750)
El Planned Unit Development ($1800) Appeal ($200)
Fi Variance ($200) Other:
Description of Request:
Pre alt 0c I Sh .n ire ss ' n re e &W enf
Application FeeS d Acct No. 10100,4403 Receipt No,
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, Manning 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 in urmd prior to withdraval.
Applicant (Please Print) Applicant's Signatur
Page I
City of Brooklyn Center- Business and Development •• 6301 Shingle Creek Pkwy - Brooklyn Center MN 55430 763.569.3300
Planning Commission Application Arm 10 -lo
r
City Use Only City Use Only City Use Only
Planning Commission Recommendation
Dates of PC Legal Notice Notices Mailed Action Taken Approved
Co Published _ Resolution No.
❑ Approved ❑ Denied this day of 20 ,
subject to the following conditions:
Chairman
City Council Action
X 1 esat of Council Legal Naliee Notices Mailed Action Taken Approved Performance
Consideration Published Resolution No. Bond
Received
W��
❑ Approved ❑ Denied this day of 20
with the following amendment:
erk/Planning Commission Secretary
Page 2
City of Brooklyn Center Qusiness and Development - 6301 Shingle Creek Pkvey - !Brooklyn Center MN 55430 763.569 -3300
I'luning Commission Appikation Fonn 10.10