HomeMy WebLinkAbout2012-021 Site & Bldg Plan City+. y y Use Only "" "�CT 0 2 2 7)2
Date Received:
BROOKLIW
CENTER Date Application Complete:
Letter of Completeness:
Planning Application Application No. ?0/01'A I
A ` lira iti eet ltg 'a i"VAnihirig and/or nginee ftg 5t i 1+ quired f riar#o tl;re� iss on cif `.
Planning,1p tion. loo applrcatas n Will ac tea ric�r,to suirh Ming. City sh ld'
b�isiness dam to rer0BW for i~ompl �nes �h e frday staator�i review acs been
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lut staff �+ i miff s .. . ,. ,is Conraplete
Application Request
(Mark all that Apply)
X Site&Building Plan Planned Unit Development Subdivision Approval
($750) ($1800) ($300)
Rezoning PUD Amendment Appeal
($1050) ($700) ($200)
Variance Special Use Permit Determination
($200) ($200) ($200)
Applicant Information:
Name: Loren Van Der Slik C/0 William D. Matzek Signature
Address: 888 E. Las Olas Blvd. Suite 600, Fort Lauderdale, FL 33301
Office Phone: (954) 302-5900 Cell:
Email: FAX: (954) 302-5901
Owner Information*(if different from Applicant):
Name: Signature
Address:
Office Phone: Cell:
Email: FAX:
* The fee title owner of the property must sign this Application to make it official
Please provide a general description of your Application Request: Submitting Site and Building Plan approval
package for LA Fitness (Building J) of Shingle Creek Crossing. 3g,400
OQ
Address/Location of Property: Xerxes Avenue No h and County Road 10, Broo lyn Center, MN
Legal Description of Property: Lot 3, Block 1 of Shingle Creek Crossing
The applicant requests processing of this application and agrees to pay to the City of Brooklyn Center,within fifteen(15)days
after mailing or delivery of the billing statement,the actual costs incurred by the City for Engineering,Planning and Legal
expenses reasonably and necessarily required by the City for the processing of the application. Such costs will be in addition to
the application fee described herein. Withdrawal of the application will not relieve the applicant of the obligation to pay costs
incurred prior to withdrawal.
Application Fee$ $750 acct No.10100-4403 Receipt No.
City of Brooklyn Center-Business and Development — 6301 Shingle Creek Pkwy — Brooklyn Center MN 55430 (763)569-3300
Planning Application Page 1 Rev 5-21-12
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Planning Commission Recommendation
Dates of PC Consideration Legal Notice Notices Mailed Action Taken Approved
Published Resolution No.
b� Z O
Approved Denied this day of �� �v' 20
su ct to the following conditions:
__Chairman
I
City Council Action
Dates of Council Legal Notice Notices Mailed Action Taken Approved Performance
Consideration Published Resolution No. Bond
Received
✓ Approved Denied this l day of / I����y�� 20
with the following amendment:
c
Clerk/Planning Commission Secretary
City of Brooklyn Center-Business and Development — 6301 Shingle Creek Pkwy — Brooklyn Center MN 55430 (763)569-3300
Planning Application Page 2 Rev 5-21-12