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*

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




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

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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