4.a3 2015_APPLICATION_FOR_CUP
File No._____________
APPLICATION FOR PLANNING AND ZONING REQUEST
City of Scandia, Minnesota
14727 209th Street North, Scandia, MN 55073
Phone 651/433-2274 Fax 651/433-5112 Web http://www.ci.scandia.mn.us
Please read before completing: The City will not begin processing an application that is incomplete. Detailed submission
requirements may be found in the Scandia Development Code, available at the City office and website (www.ci.scandia.mn.us) and in
the checklist forms for the particular type of application. Application fees are due at the time of application and are not refundable.
1. Property Location: (street address, if applicable)
2. Washington County Parcel ID:
3. Complete Legal Description: (attach if necessary)
4. Owner(s):
Phone:
(h)
(b)
Street Address:
E-Mail:
City/ State:
Zip:
5. Applicant/Contact Person: Phone:
(h)
(b)
Street Address (Mailing):
E-Mail:
City/ State:
Zip:
6. Requested Action(s): (check all that apply)
____ Variance
____ Variance Extension
____ Conditional Use Permit (CUP)
____ CUP Extension
____ CUP/ Open Space Subdivision.
____ CUP/ Planned Unit Development
____ Interim Use Permit (IUP)
____ Administrative Permit
(type)____________________
____ Site Plan Review
(type)____________________
____ Site Plan Modification
____ Site Plan Extension
____ Sign (Permanent)
____ Amendment (Development Code )
____ Amendment (Comp. Plan )
____ Subdivision, Minor
____ Subdivision, Preliminary Plat/Major
____ Subdivision, Final Plat
____ Environmental Review
____ Wetland Review
7. Brief Description of Request: (attach separate sheet if necessary; include Variance Rationale if
necessary)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
8. Project Name:
I hereby apply for consideration of the above described request and declare that the information and materials submitted
with this application are complete and accurate. I understand that no application shall be considered complete unless
accompanied by fees as required by city ordinance. Applications for projects requiring more than one type of review
shall include the cumulative total of all application fees specified for each type of review. I understand that applicants
are required to reimburse the city for all out-of-pocket costs incurred for processing, reviewing and hearing the
application. These costs shall include, but are not limited to: parcel searches; publication and mailing of notices; review
by the city’s engineering, planning and other consultants; legal costs, and recording fees. An escrow deposit to cover
these costs will be collected by the city at the time of application. The minimum escrow deposit shall be cumulative total
of all minimum escrow deposits for each type of review required for the project, unless reduced as provided for by
ordinance. The city may increase the amount of the required escrow deposit at any time if the city’s costs are reasonably
expected to exceed the minimum amount. Any balance remaining after review is complete will be refunded to the
applicant. No interest is paid on escrow deposits.
PLEASE NOTE: If the fee owner is not the applicant, the applicant must provide written authorization by the fee
owner in order for this application to be considered complete.
Property Fee Owner Signature(s)
Date:
Applicant Signature(s) Date:
For City Use Only
Application Fees: _______________________
Escrow Deposit: _______________________
City of Scandia, Minnesota
Planning and Zoning Applications Fee Schedule
Excerpt of Ordinance No. 159, Adopted December 16, 2014
Application Type Application Fee Escrow Minimum
Variance
$150.00 $325.00
Variance Extension $50.00
Conditional Use Permit (CUP)
Open Space Conservation Subdivision CUP $750.00 $2,000.00
Planned Unit Development CUP $500.00 $550.00
All other Conditional Use Permits $200.00 $300.00
CUP Extension $50.00
Interim Use Permit $200.00 $325.00
Administrative Permits
Driveway Access $50.00 $500.00
Grading/Land Alteration $50.00 $350.00
Land Clearing $75.00
Lot Line Adjustment/Lot Consolidation $50.00 $200.00
Cell Tower Administrative Permit $50.00 $250.00
All other Administrative Permits $50.00
Site Plan Review
Pre-application sketch review, Open Space Conservation
Subdivision
$500.00 $500.00
Pre-application sketch review, Planned Unit Development $500.00 $500.00
Pre-application sketch review, all other $50.00
Site Plan Review, Minor Projects $100.00 $250.00
Site Plan Review, Major Projects $250.00 $500.00
Plan Modification $50.00
Site Plan Extension $50.00
Amendment
Rezoning (Map Amendment) $500.00 $575.00
Amendment—Development Code Text $500.00 $500.00
Amendment—Comprehensive Plan Map $500.00 $575.00
Amendment—Comprehensive Plan Text $500.00 $500.00
Sign (permanent) $25.00
Environmental Review
EAW (Environmental Assessment Worksheet) $750.00 $2,000.00
EIS (Environmental Impact Statement) $750.00 $10,000.00
Subdivision
Minor Subdivision $100.00 $550.00
Preliminary Plat/ Major Subdivision $250.00 $1,000.00
Final Plat $200.00 $1,000.00
Wetland Review $100.00 $500.00
PARCEL NUMBER: 18.032.19.33.0004
LEGAL DESCRIPTION: SW1/4-SW1/4 EXC THOSE PTS THEREOF LYING W OF CTR LN HWY 95 AND ALSO EXC PT
SW1/4-SW1/4 BEG AT A PT ON THE S LN OF SD SEC 18 DIST OF 171FT E OF SW COR THEREOF RUN RUN NELY AT
ANG OF 107DEG03' WITH SD S SEC LN MEAS FROM W TO N DIST OF 263.5FT THN DFL TO THE RT AT ANG OF
72DEG57' DIST OF 113FT M/L TO PT OF BEG WHICH PT BEING ON ELY R/W LN HWY 95 AS NOW ESTBL & BEING
DIST OF 100FT FROM CTR LN OF HWY 95 MEAS AT RT ANG TO SD CTR LN THN CONT ELY DIST OF 375.4FT THN
DFLC TO LFT AT ANG OF 89DEG00' DIST OF 1048.3FT DIST OF 1048.3FT THN DEFL TO LFT AT AN ANG OF
90DEG32' DIST OF 89DEG00' DIST OF 1048.3FT DIST OF 1048.3FT THN DEFL TO LFT AT AN ANG OF 90DEG32'
DIST OF 75.5FT TO A PT ON ELY R/W LN OF HWY 95 NOW ESTBL & DIST OF 100FT FROM CTR LN OF HWY 95 CTR
LN MEAS AT RT ANG TO SD HWY 95 CTR LN THN RUN SWLY ALG ELY R/W LN TRK HWY 95 TO PT OF BEG ALSO
EXCEPT 91019-3155 SECTION 18 TOWNSHIP 032 RANGE 019
PARCEL NUMBER: 18.032.19.33.0003
LEGAL DESCRIPTION: PT SW1/4-SW1/4 BEG AT A PT ON THE S LN OF SD SEC 18 DIST OF 171FT E OF SW COR
THEREOF RUN RUN NELY AT ANG OF 107DEG03' WITH SD S SEC LN MEAS FROM W TO N DIST OF 263.5FT THN
DFL TO THE RT AT ANG OF 72DEG57' DIST OF 113FT M/L TO PT OF BEG WHICH PT BEING ON ELY R/W LN HWY 95
AS NOW ESTBL & BEING DIST OF 100FT FROM CTR LN OF HWY 95 MEAS AT RT ANG TO SD CTR LN THN CONT ELY
DIST OF 375.4FT THN DFLC TO LFT AT ANG OF 89DEG00' DIST OF 1048.3FT DIST OF 1048.3FT THN DEFL TO LFT
AT AN ANG OF 90DEG32' DIST OF 75.5FT TO A PT ON ELY R/W LN OF HWY 95 NOW ESTBL & DIST OF 100FT FROM
CTR LN OF HWY 95 CTR LN MEAS AT RT ANG TO SD HWY 95 CTR LN THN RUN SWLY ALG ELY R/W LN TRK HWY
95 TO PT OF BEG SECTION 18 TOWNSHIP 032 RANGE 019
PARCEL NUMBER: 18.032.19.32.0003
LEGAL DESCRIPTION: PT NW1/4-SW1/4 DESC AS FOLL COM AT W1/4 COR SD SEC THN S00DEG E ASM BRG ALG W
LN SD SEC DIST 441.6FT THN N89DEG 58'E DIST 860.6FT TO POB ON C/L HWY 95 THN CONT N89DEG58'E DIST
573FT M/L TO E LN SD NW 1/4-SW1/4 THN SLY ALG SD E LN DIST 863FT M/L TO SE COR SD NW 1/4-SW1/4 THN
WLY ALG S LN SD NW1/4-SW1/4 DIST 874FT M/L TO C/L SD HWY 95 THN NELY ALG SD C/L DIST 913FT M/L TO
POB SUBJ TO EASE SECTION 18 TOWNSHIP 032 RANGE 019
PARCEL NUMBER: 19.032.19.22.0001
LEGAL DESCRIPTION: NW1/4-NW1/4 EXC 91019-3300 & 3250 SUBJECT TO EASEMENT EXC 91019 3260 EXC 91019-
3155 AND EXCEPT:PT OF NW1/4-NW1/4 OF S19T32R19 WHICH LIES W OF C/L MN HWY 95 EXCEPT S 631.5FT AND
EXCEPT:PT NW1/4-NW1/4 S19T32R 19 WHICH LIES SWLY OF SWLY R/W LINE OF CTY RD 53 & NELY OF LINE RUN
PARL WITH & DIST 33FT SLY OF LINE DESC AS: FROM A POINT ON N LINE OF SD SEC 19 DIST OF 170.39FT E OF
NW COR THEREOF RUN SWLY AT ANG OF 73DEG21'34" FROM SD N SEC LINE (MEASURED FROM W TO S) DIST OF
12.89FT THN DEFL TO LFT AT AN ANGLE 35DEG46'22" DIST 710.9FT TO POINT OF BEG OF LINE 1 TO DESC THN
DEFLECT TO LFT AT AT ANGLE 80DEG00'00" DIST 24.67FT THN DEFLECT TO RT ON TANG CRV HAVING RADIUS
230FT AND A DELTA ANGLE 62DEG39'19" DIST 251.51FT THN ON TANG TO SAID CRV 178.05FT THN DEFL TO LEFT
ON TANG CRV HAVING RAD OF 1432.39FT AND A DELTA ANG 14DEG07'28" DIST 353.11FT THN ON A TANG TO
SAID CRV DIST OF 54.87FT AND THERE TERM BEING STATE HWY PRCL 216 (S.P. 8210) SECTION 19 TOWNSHIP
032 RANGE 019
PARCEL NUMBER: 19.032.19.21.0002
LEGAL DESCRIPTION: NE1/4-NW1/4 WEST OF RR EXC PORTION PLATTED AS OTISVILLE SECTION 19 TOWNSHIP
032 RANGE 019
PARCEL NUMBER: 18.032.19.34.0001
LEGAL DESCRIPTION: SE1/4-SW1/4 EXC THAT PT LYING WITHIN 200 FT WIDE R/W OF SOO LINE RR & EXC PT OF
S 198 FT LYING E OF ELY LINE OF RR R/W EXC 18.032.19.43.0001 SECTION 18 TOWNSHIP 032 RANGE 019
PARCEL NUMBER: 18.032.19.31.0001
LEGAL DESCRIPTION: PT NE1/4-SW1/4 183219 DESC AS FOLL BEG AT SW COR THEREOF THN N ALG W LN SD
NE1/4-SW1/4 DIST 280.5FT THN DEFL RT 75DEG DIST 577.5FT THN DEFL RT 75DEG TO S LN SD NE1/4-SW1/4
THN WLY ALG SD S LN TO POB SECTION 18 TOWNSHIP 032 RANGE 019