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HomeMy WebLinkAbout2012-019 PUD Amendment City Use Only Planning Commission Application Date Received U I l 2 s (sr Please Print Clearly or Type Application No. I3�) in P Address/Street Location of Property Xerxes Ave North and County Road 10, Brooklyn Center, MN Legal Description of Property Shingle Creek Crossing ,2nd Addition 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 Stan Der Slik Name Loren Van Der Slik 888 E. Las Olas Blvd. Suite 600 888 E. 'Las Olas Blvd. Suite 600 Address Fart Lauderdale, FL 33301 Address Fort Lauderdale, FL 33301 Phone (954) 302-5900 Fax (954) 302-5901 Phone (954) 302-5900 Fax (954) 302-5901 Email Email Type of Request: Rezoning($1050) F� Special Use Permit($200) Subdivision Approval($300) ❑ Site&Building Plan Approval($750) Planned Unit D velopment(SISN) F-1 Appeal($200) X"In onetl, Variance($200) Other: ,p r- Description of Request: PUD Amendment 3 to the approved PUD Amendment 2 Application Fee$ *1r.10' Acct o.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,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. Loren Van Der Slik C/0 William D. Matzek Applicant(Please Print) Applicant's Signature Page 1 City of Brooklyn Center-Business and Development-6301 Shingle Creek Pkwy-Brooklyn Center MN 55430 763-569-3305 Planning Commission Application Form 3-11 J 0 1,Y „ city Planning Commission Recommendation Dates of PC Legal Notice Notices Mailed Action Taken Approved Consideration Published Resolution No. ,/ 30_ -30_ - — �e w'' ,ems- -Z, , Approved Denied this day of 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 20 with /Approved Denied this t day of 20 with the following amendment: Clerk/Planning Commission Secreta Page 2 City of Brooklyn Center-Business and Development-6301 Shingle Creek Pkwy-Brooklyn Center MN 55430 763-569-3305 Planning Commission Application Form 3-11