Form Date: 10-02-00 - The City of Boca Raton

CITY OF BOCA RATON CITY OF BOCA RATON – DEVELOPMENT SERVICES

DEVELOPMENT SERVICES DEPARTMENT 201 WEST PALMETTO PARK ROAD • BOCA RATON, FLORIDA 33432 -3795 TELEPHONE (561) 393-7789  FAX (561) 393-7784

SPECIAL CASE APPROVAL APPLICATION

SC

TO ALL APPLICANTS: PLEASE CONTACT A CITY PLANNER AT (561) 393-7789 PRIOR TO FILING THIS APPLICATION

APPLICATION FEE: Choose One*     

     

Coastal Construction Control Line Setback Variance ($3,745) Comprehensive Plan Text or Map Series Amendment (Under 10 acres) ($6485) Comprehensive Plan Text or Map Series Amendment (10 or more acres) ($8795) Comprehensive Plan Text Only ($8795) Development of Regional Impact (DRI)  New Application ($11,225)  Substantial Deviation ($8,040)  NOPC ($5,685) Historic Designation ($2,185) Non-Concurrent Parking Agreement ($750) Technical Deviation from Chapter 28 (Parking) ($3,390) Technical Deviation from Chapter 23 (Access/reservoirs) ($4,085) Sale of City-Owned Property ($3590) Voluntary Annexation ($5,465)

* Fee includes the required advertising deposit, administrative processing and radius map fees (when required). Unused advertising monies will be returned to the applicant. Applicant will be billed by the City for costs to prepare mailing labels at $5 per page and first class postage. Please refer to the City's adopted fee schedule for a specific breakdown of fees.

For Official Use Only Date received:

Case No.

HTE No.

Date complete:

Received by:

Name of Project Address or General Location

Is this a new SC submittal (Y/N)?

If this is a resubmittal, when was the project previously submitted?

APPLICANT INFORMATION (All owners of real property within the boundary of a proposed plan are required to consent to

this application. Please attach additional sheet(s) or notarized authorization(s) if necessary.) CITY OF BOCA RATON – DEVELOPMENT SERVICES APPLICANT Applicant’s Agent (if acting as authorized agent of a business entity) Relationship of Applicant to Owner Address Phone Facsimile Signature

Email

Date

OWNER (if different from applicant) Address Phone Facsimile Signature

Email

Date

REPRESENTATIVE Company/Firm Address Phone Facsimile Signature

Email

Date

SPECIAL CASE APPROVAL APPLICATION CITY OF BOCA RATON – DEVELOPMENT SERVICES SUBMITTAL CHECKLIST

SC SUBMITTED YES

TO ALL APPLICANTS: Each item included in the submission should be checked-off below. Items that are not submitted may delay the project by making it impossible to fully review the project and may require submission of additional materials. The following submittal requirements apply to SC applications:

NO Five (5) signed and sealed copies of the written legal description, one (1) disk containing the legal description in WORD format, and five (5) signed and sealed surveys prepared by a registered land surveyor of the entire property encompassing the application, including the centerline grades of the roadways abutting the property. One (1) disk with electronic files in .pdf format of the entire application submittal, including, but not limited to, the application, project narrative, landscape/architectural plans, survey, and any other information requested by the City. This disk is in addition to the two (2) disks required for the traffic and/or parking accumulation studies. Five (5) hard copies of a signed and sealed traffic study and/or parking accumulation study and two (2) electronic .pdf files of the traffic and/or parking study if required by the City's Traffic Engineer. One (1) unity of title fully executed by all property owners and their respective mortgagees using the City's standard unity of title form for those projects having multiple parcel control numbers or comprised of more than one (1) platted lot. If the executed unity of title is not submitted, the application will not be scheduled for any public hearing until such time as the executed form is submitted. If applicable, eighteen (18) copies of applicant's response letter demonstrating that all comments provided by Planning Advisory (PA) review have been addressed or satisfied. Twelve (12) copies of any proposed architectural elevations and floor plans. Twelve (12) sets of signed and sealed plans drawn in engineering scale, including north arrow and general location map, on 24" x 36" sheets, folded to 9" x 12". Plans shall depict or describe each of the following, if applicable: A

Name and address of the owner(s), applicant(s) and professionals responsible for preparing the plan.

B

Title and/or name of the project, project address and developer/builder.

C

Date, location map, north arrow and graphic scale. The location map and plan should be oriented in the same direction.

D

Property lines and existing (with dimensions, sizes, grades, slopes and details where applicable):  buildings with all building entrances identified;  building setbacks and distances between buildings;  parking areas and structures, regular and handicapped parking spaces, loading spaces and drives;

 watercourses and bodies;  sidewalks, traffic control devices and signage, bikepaths, trails and other CITY OF BOCA RATON – DEVELOPMENT SERVICES mobility or roadway improvements;  seawalls;  open and green space;  landscape buffers;  furnishings, including bicycle racks, benches, trash receptacles and decorative lighting;  walls, fences and berms;  dumpster enclosures and details/elevations;  recreational amenities;  site and building lighting; and  any other additional information as may be requested by the Development Services Department to allow for review of the plan.

E

Site data for adjoining properties, including:  project or property owner's name;  existing land use;  zoning;  density;  public facilities; and  natural features.

F

Site data addressing existing conditions, including:  zoning and future land use designation;  acreage and square footage of the each lot and the lands encompassed by the entire plan;  square footage of each structure;  floor area ratio for plans including non-residential development;  density, number and type (number of bedrooms) of dwelling units, minimum unit size and average unit size for plans including residential development;  existing and maximum allowable height of all structures;  parking calculations, including bicycle parking (required and proposed);  open space;  water and sewer usage;  required building setbacks; and  any other additional information as may be requested by the Development Services Department to allow for review of the plan.

Eighteen (18) hard copies and one (1) disk with files in .pdf format of the proposed text amendment, DRI document/amendment, historic designation supporting documentation, non-concurrent parking agreement or annexation study. One (1) hard copy and one (1) disk with files in .pdf format of the completed comprehensive plan amendment checklist and supporting documentation (See Comprehensive Plan Supplemental Application).

I hereby state that I have reviewed the information and exhibits submitted with the application and have determined, as evidenced by the checked boxes above, that all required information set forth herein has been provided, if applicable, for the proposed project. I further state to the best of my knowledge that the information provided is accurate, complete and correct.

Signed:

Date:

CITY OF BOCA RATON CITY OF BOCA RATON – DEVELOPMENT SERVICES

DEVELOPMENT SERVICES DEPARTMENT 201 WEST PALMETTO PARK ROAD • BOCA RATON, FLORIDA 33432 -3795 TELEPHONE (561) 393-7789  FAX (561) 393-7784

DEVELOPMENT APPLICATION

REQUIRED PROJECT DATA TO ALL APPLICANTS: This form must be completed and submitted with all development applications filed with the Development Services Department for processing. Do not leave any information blank. If the requested information is not applicable or unknown, please indicate as “N/A” or “?.” No development application will be considered complete without the submission of this completed form. Name of Project Street Address or General Location Parcel Control/Identification No. (PCN) Site (Acres)

Site (Square Feet)

Existing Zoning

Proposed Zoning

Existing Future Land Use Designation

Proposed Future Land Use Designation

PROJECT DESCRIPTION Please provide a brief statement of the development proposal or request – attach a separate letter if necessary.

Proposed Use

Specific Type (e.g. bank, fastfood, house of worship, apartments, grocery store, outdoor eating area, etc.)

Square Footage/Dwelling Units/Rooms/Beds Existing

Demolished

Stories

New

Office (SF) Retail/Commercial (SF) Restaurant (SF) Hotel (Rooms) Hospital (SF/Beds) Institutional (SF) Residential (DU) Other (SF) PROJECT TOTAL PREVIOUS APPROVALS: Does the Project have any previous approvals? (Check all that apply.) Conditional Use (CA)

Rezoning (UC)

Master Plan (PUD/SC)

Future Land Use Amendment

Plan (SPA) CITYSite OF BOCA RATON – DEVELOPMENT SERVICES Individual Development Approval (IDA)

Plat (SUB) Other

If you are aware of any previously approved ordinances or resolutions/development orders related to the Project or the property, list them below.

SETBACKS: Provide the required and proposed setbacks for each development plot or parcel. (Attach additional sheets if more than two (2) plots or parcels are included or proposed.) Parcel 1 Yard (Provide description of location if necessary)

Parcel 2

Required (Feet)

Proposed (Feet)

Yard (Provide description of location if necessary)

Front

Front

Side

Side

Street Side

Street Side

Rear

Rear

Other

Other

Required (Feet)

Proposed (Feet)

PARKING Existing

Required

Proposed

Parking Spaces TECHNICAL DEVIATIONS: Does the Project require any Technical Deviations? Y

N

Explain

Chapter 23 (Driveway Design) Chapter 28 (Parking Requirements) BUILDING HEIGHT (Attach additional sheets if more than two (2) buildings are included or proposed.) Building 1 Existing

Proposed

Building 2 Permitted

Existing

Proposed

Permitted

Height (Feet) LEGAL DESCRIPTION: Please provide the legal description for the Project in the space below. (An attached legal description may be provided.)

CITY OF BOCA RATON – DEVELOPMENT SERVICES

DISCLOSURE OF OWNERSHIP INTERESTS – PROPERTY and *APPLICANT TO BE COMPLETED AND EXECUTED BY THE PROPERTY OWNER(S) AND BY APPLICANT (*ONLY WHEN THE APPLICANT IS NOT THE OWNER OF THE SUBJECT PROPERTY) FOR EACH APPLICATION FOR: Site Plan Approval, Conditional Use Approval, Master Plan Approval, Comprehensive Plan Future Land Use Map Amendment Approval, Rezoning Approval, etc. (“Development Order Approval”)

TO:

DEVELOPMENT SERVICES DIRECTOR, OR HIS OR HER OFFICIALLY DESIGNATED REPRESENTATIVE

STATE OF FLORIDA COUNTY OF PALM BEACH AS TO PROPERTY OWNER: BEFORE

ME,

the

undersigned

authority, this day personally appeared , hereinafter referred to as “Affiant One,” who being by me first duly sworn, under oath, deposes and states as follows: 1.(a) Affiant One is the [ ] individual or [ ] [position - e.g., president, partner, trustee] of [name and type of entity - e.g., ABC Corporation, XYZ Limited Partnership] that holds an ownership interest in real property legally described on the attached Exhibit “A” (the “Property”). The Property is the subject of an application for Development Order Approval with the City of Boca Raton. 1.(b) Affiant One’s address is:

CITY OF BOCA RATON – DEVELOPMENT SERVICES

1.(c). Attached hereto as Exhibit “B” is a complete listing of the names and addresses of every person or entity having a five (5%) percent or greater interest in the Property. Disclosure does not apply to an individual’s or entity’s interest in any entity registered with the Federal Securities Exchange Commission or registered pursuant to Chapter 517, Florida Statutes, whose interest is for sale to the general public. AS TO APPLICANT: BEFORE

ME,

the

undersigned

authority,

this

day

personally appeared , hereinafter referred to as “Affiant Two,” who being by me first duly sworn, under oath, deposes and states as follows: 2.(a) Affiant Two is the [ ] individual or [ ] [position - e.g., president, partner, trustee] of [name and type of entity e.g., ABC Corporation, XYZ Limited Partnership] (hereinafter “Applicant”). Applicant seeks Development Order Approval for real property legally described on the attached Exhibit “A” (the “Property”). 2.(b) Affiant Two’s address is:

2.(c). Attached hereto as Exhibit “C” is a complete listing of the names and addresses of every person or entity having a five (5%) percent or greater interest in the Applicant. Disclosure does not apply to an individual’s or entity’s interest in any entity registered with the Federal Securities Exchange Commission or registered pursuant to Chapter 517, Florida Statutes, whose interest is for sale to the general public.

CITY OF BOCA RATON – DEVELOPMENT SERVICES

AS TO PROPERTY OWNER AND/OR APPLICANT (only when the Applicant is not the owner of the subject property): 3. Affiant One and/or Affiant Two acknowledge(s) that this Affidavit is given to comply with City of Boca Raton policy, and will be relied upon by the City of Boca Raton in its review of an application for Development Order Approval affecting the Property. Affiant One further acknowledges that he or she is authorized to execute this Disclosure of Ownership Interests on behalf of any and all individuals or entities holding a five (5%) percent or greater interest in the Property. Affiant Two further acknowledges that he or she is authorized to execute this Disclosure of Ownership Interest on behalf of the Applicant. 4. Affiant One further acknowledges that he or she shall by affidavit amend this disclosure to reflect any changes to ownership interests in the Property that may occur before the date of final public hearing on the application for De velopment Order Approval. Affiant Two further acknowledges that he or she shall by affidavit amend this disclosure to reflect any changes to ownership interests in the Applicant that may occur before the date of final public hearing on the application for De velopment Order Approval. 5.

Affiant One and Affiant Two further state that Affiant One and Affiant Two are familiar with the nature of an oath and with the penalties provided by the laws of the State of Florida for falsely swearing to statements under oath.

6. Under penalty of perjury, Affiant One and Affiant Two declare that Affiant One and Affiant Two have examined this Affidavit and to the best of Affiant One’s and Affiant Two’s knowledge and belief it is true, correct, and complete.

CITY OF BOCA RATON – DEVELOPMENT SERVICES

FURTHER AFFIANT ONE SAYETH NAUGHT.

, Affiant One (Print Affiant One Name)

The foregoing instrument was acknowledged before me this 20 , by known to me or [ ] who as identification and who did take an oath.

day of , , [ ] who is personally has produced

Notary Public

(Print Notary Name) NOTARY PUBLIC State of Florida at Large My Commission Expires:

CITY OF BOCA RATON – DEVELOPMENT SERVICES

FURTHER AFFIANT TWO SAYETH NAUGHT.

, Affiant Two (Print Affiant Two Name)

The foregoing instrument was acknowledged before me this 20 , by known to me or [ ] who as identification and who did take an oath.

day of , , [ ] who is personally has produced

Notary Public

(Print Notary Name) NOTARY PUBLIC State of Florida at Large My Commission Expires:

CITY OF BOCA RATON – DEVELOPMENT SERVICES

EXHIBIT “A” PROPERTY

CITY OF BOCA RATON – DEVELOPMENT SERVICES

EXHIBIT “B” DISCLOSURE OF OWNERSHIP INTERESTS - PROPERTY Affiant One must identify all entities and individuals owning five (5%) percent or more ownership interest in the Property. Affiant One must identify individual owners. For example, if Affiant One is an officer of a corporation or partnership that is wholly or partially owned by another entity, such as a corporation, Affiant One must identify the other entity, its address, and the individual owners of the other entity. Disclosure does not apply to an individual’s or entity’s interest in any entity registered with the Federal Securities Exchange Commission or registered pursuant to Chapter 517, Florida Statutes, whose interest is for sale to the general public.

Name

Address

CITY OF BOCA RATON – DEVELOPMENT SERVICES

EXHIBIT “C” DISCLOSURE OF OWNERSHIP INTERESTS - APPLICANT Affiant Two must identify all entities and individuals owning five (5%) percent or more ownership interest in Applicant’s corporation, partnership, or other principal, if any. Affiant Two must identify individual owners. For example, if Affiant Two is the officer of a corporation or partnership that is wholly or partially owned by another entity, such as a corporation, Affiant Two must identify the other entity, its address, and the individual owners of the other entity. Disclosure does not apply to an individual’s or entity’s interest in any entity registered with the Federal Securities Exchange Commission or registered pursuant to Chapter 517, Florida Statutes, whose interest is for sale to the general public.

Name

Address

CITY OF BOCA RATON – DEVELOPMENT SERVICES City of Boca Raton Planning and Zoning Division

AUTHORIZED AGENT FORM

l,

_______________as owner of ____ (print name of owner)

do hereby authorize

____________________ (print property address)

.

_______________ to act as my agent in submitting

(print name of authorized agent) development applications to the City of Boca Raton. I understand that I am the owner of record responsible for the development applications submitted by my agent referenced above. I further understand that each time my agent submits an application or signs any required documents, that the individual must exhibit this authorization form at the discretion of Planning and Zoning staff.

The Owner's Signature Is to Be Notarized

(Owner's Signature)

(Date)

STATE OF FLORIDA COUNTY OF ________ The foregoing instrument was acknowledged before me this

__day of _____________,

20_ _, By _____________________, who is personally known to me ( ) or has provided the following identification

_____________________

Notary Public Signature

_____________ Notary Public Stamp Here