HomeMy WebLinkAboutApplicationsFOR OFFICE USE ONLY
CASE NO. ~'k~-i S
DATE SUBM~I ATTED
C)
CONDITIONAL USE PERMIT APPLICATION
(GENERAL) ~~ [ j~m~~,
/ Minimum Requirements
5150.00 application fee (or $75.00 for in-house child care - max. 7 children).
1~ ~c Tea (10) copies of site plan which includes requirements for site plan proposals as listed on attached sheet. This
/ site plan will be reviewed by Staff, after which ter, (10) copies of revised site plan will be required.
V Detailed explanation of proposed use including hours of opexatioq anticipated traffic, number of employees,
number of students, children, ages of children, church members, etc., as applicable.
~~~ If sign is planned for project, site plan should include sign elevation and details. ff sign details are not
included on plans submitted with this applicatioq any future sign may have to be considered as a separate
conditional use pemut and all of the above requirements must be repeated.
Use Only ~ Site Plan Only O Site Plan and Use
Conditional Uses: (check one)
O Community Buildings
~ Convalescent Homes
O Hospitals
O In Home Child Care
Q Medical Clinics
O Municipal Service Facilities
O Nursing Homes
Parking Lots
~ Pharmacies
O Public Libraries
O Sanitariums
C1 Telephone Exchange
O Veterinary Clinic _
NAME OF PROJ~~ECnnTIl ~~_
ADDRESS -~~1
LEGAL DESCRIPTION
APPLICANT (Primary C
Name
Street Address ~jt~
O
Q
O
Q
Q
O
Q
O
Q
O
O
Q
Apartment Hotels (C-1)
Bed and Breakfasts (NG-3)
Convenience Store (C-B)
Dry Cleaners (C-B)
Duplexes (R-3)
Fraternity/Sorority Houses (R-5, R-6, C-l, C-2, NG-1, NG-2, NG-3, M-1)
Funeral Houses (C N, M-1, M-2, A-P, C-l, C-2, C-3)
Group Housing (R-S, R-6, C-1, C-2, NG-1, NG-2, NG-3)
Large Recycling Collection Facilities (C-NG, A-P, C-1, C-2, C-3)
Major WTF (AD, AP, M-l, R&D, C-1, C-2, C-3)
Restaurants (C-3)
Telecommunication Towers (A-0, A-P, M-1)
Other (Specify -__- _ -__)
State ~_ Zip Code`s ~ I
Phone Number C('~?,~Q~ ~ (p~j Fax Number
PROPERTY OWNER' S
Name
Street Address -
State ~~
Phone Number
.TION:
Zip Code
City
_ E-Mail Address _
Fax Number
,` ~-- cue - GENERAI. 1 of 3
CUPAGEN.DGC 03/23/99
ARCHITECT R ENGINEER'S INFORMATION:
Name
Sweet Address ~Jt ~
State ~_ Zip Co/d,,e~ '~'1 ~O
Phone Number ~• ~p17• ~~D~J Fax Numbe
OTHER CONTACTS (Please specify type of contact, i.e. prof
Name - I ` Q 5
Street Address 'l0 1~'b~ filf~
State ~_ Zip Code "l~'l ~L
Phone Number ~J ~Q1 • ~(a(D Fax Num
PRESENT USE OF PROPERTY
-Mail Address
~.. ~I J~ity ~
E-Mail Address
ber ~ Z • ~2'
PROPOSED USE OF PROPERTY ~~~~' 1MIlA ~O~
Ci;fRRENT ZONING OF PROPERTY L-
VARIANCE(S) REQUESTED AND REASON(S) _~~,Q,
NUMBER OF PARKING SPACES REQUIRED
NUMBER OF PARKING SPACES PROVIDED
Q RESIDENTIAL COMMERCIAL
Total Acreage Total Acreage QtCf ~ S
Housing Units Building Sq. Ft.
Floodplain Acreage
APPLICATION WILL NOT BE CONSIDERED COMPLETE WITHOUT THE FOLLOWING INFORMATION
ADDRESSED:
State how the following issues will be addressed:
1. Parking.
r
"'" CUP -GENERAL "" ` -5 ~ S~~Q,Q/~„
CUPAGEN.DOC 03/25/99
2 of 3
manager, potential buyer, local contact, etc.)
2 Screening of offensive areas (wash, loading areas, transformers, utility connections, detention ponds, etc.).
Traffic impacts.
-~as~
4.
Protection of neighborhoods.
that all of the information contained in this application is true and correct.
v r~~~Vv
Date
~ CUP -GENERAL. 3 of 3
CUPAGEN.L~OC 03/25199