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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