APPLICATION FOR ADMINISTRATIVE SITE PLAN REVIEW (URBAN CENTER DISTRICT) GENERAL INFORMATION The following items must be submitted to the Administrative Review Section for review of proposed Mixed-Use developments in the Urban Center District: 1 2 copy of application (attached) sets of plans (site, landscaping, floor plans, typical lot layout, elevation) & CD with plans & docs (Use PDF format. Layered plans must be flattened) 1 set of plans not to exceed 8½” x 11” in size 1 copy of legal description 1 copy of current valid survey Fees (See fee schedule attached) The Site Plan must contain a complete legend. Landscape plans, accompanied by a Landscape Legend and a signed Certificate of Compliance, along with floor plans, elevations and typical lot layout (See Attached). The plan will be reviewed by the Department of Planning and Zoning, Public Works Department, Department of Resources Management (DERM), Park and Recreation Department and Fire Department and for compliance with zoning regulations and for compliance with site plan review criteria and other requirements. Applicants will be notified by the Zoning Processor of required revisions or corrections to the plan within 21 days from the date of submission. Revised plans, once received, will again be reviewed by all departments, and if approved will proceed for further staff review and final review resulting in written approval or denial of the plan. FIRE RESCUE DEPARTMENT reviews and comments on applications. Call (786) 331-4540 to obtain information required for proper plans review by this department. AVIATION DEPARTMENT reviews and comments on applications located within certain areas of all airports located in Miami-Dade County. Additional fees will be assessed for applications exceeding certain height thresholds. Call (305) 876-0479 for information on height thresholds. FEES: Be advised that a fee is required for DERM and for the Public Works Department. (See attached fee schedule). An appointment is required to submit the application when your site plan review application is complete and ready to submit. Please call the Zoning Administrative Review Section at (305) 375-2640 and schedule an appointment to submit the ASPR application. Asprappsfor UCD/sbl-12/29/06 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR ADMINISTRATIVE SITE PLAN REVIEW (Urban Center District) S ________ T ________ R ________ FOLIO NUMBER: 30-_______________________ (1) Received Stamp APPLICANT’S NAME: ____________________________________________________ ADDRESS: ____________________________________________________________ PHONE: ______________ FAX: ________________ E-MAIL: ____________________ (2) PROPERTY OWNER’S NAME: _____________________________________________ ADDRESS: ____________________________________________________________ PHONE: ______________ FAX: ________________ E-MAIL: ____________________ (3) CONTACT PERSON NAME: _______________________________________________ ADDRESS: ____________________________________________________________ PHONE: ______________ FAX: ________________ E-MAIL: ____________________ (4) NAME OF PLAN: ________________________________________________________ NO. OF SHEETS ________________________________________________________ PREPARED BY: ________________________________________________________ DATE OF PLAN: ________________________________________________________ NUMBER OF UNITS: ____________________________________________________ PROPOSED USE: _______________________________________________________ (5) AREA OF UCD DEVELOPMENT: NARANJA ______________ PERRINE ___________ PRINCETON ___________ CUTLER RIDGE ______ GOULDS _______________ OJUS ______________ (6) SIZE OF PROPERTY: ___________________________________________________ DEVELOPMENT TYPE: __________________________________________________ ADDRESS OR LOCATION OF PROPERTY: __________________________________ ______________________________________________________________________ ______________________________________________________________________ (7) LEGAL DESCRIPTION OF PROPERTY: ____________________________________ ______________________________________________________________________ ______________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com FEE SCHEDULE ADMINISTRATIVE SITE PLAN REVIEW FOR URBAN CENTER DISTRICT Z707 Basic Fee $2,201.63 Z705 Number of Units ($366.94 per 15 units or portion thereof) _________ Size of Property ($880.65 per 10 acres or portion thereof) _________ Size of Buildings ($293.55 per 5,000 sq. ft. or portion thereof) _________ Z708 Z709 Z109 DERM $250.00 Z119 PUBLIC WORKS $250.00 Z120 FIRE $190.00 Z060 Web Document Fee $ 77.25 Subtotal _________ CN02 6% Concurrency Fee _________ 8% Surcharge _________ Total $ _________ REVISIONS: First Revision Subsequent Revisions Z711 Revision $880.65 (per subsequent revision) 8% Surcharge No Charge __________ __________ NOTE: 8% surcharge will be added to all fees except DERM and concurrency. Rev. 1/29/07; 1/6/09 American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT’S AFFIDAVIT The Undersigned, first being duly sworn depose that all answers to the questions in this application, and all supplementary documents made a part of the application are honest and true to the best of (my)(our) knowledge and belief. (I)(We) understand this application must be complete and accurate before the application can be submitted . ************************************************************************************************************************************** OWNER OR TENANT AFFIDAVIT (I)(WE), (I am)(we are) the owner , being first duly sworn, depose and say that tenant of the property described and which is the subject matter of the application . . Signature Signature Sworn to and subscribed to before me this _____ day of ___________, ______. Notary Public: Commission Expires: ***************************************************************************************************************************************************** CORPORATION AFFIDAVIT (I)(WE), , being first duly sworn, depose and say that (I am)(we are) the President Vice-President Secretary Asst. Secretary of the aforesaid corporation, and as such, have been authorized by the corporation to file this application; and that said corporation is the owner tenant of the property described herein and which is the subject matter of the proposed application. Attest: Authorized Signature Office Held (Corp. Seal) Sworn to and subscribed to before me this _____ day of ___________, ______. Notary Public: Commission Expires: ***************************************************************************************************************************************************** PARTNERSHIP AFFIDAVIT (I)(WE), , being first duly sworn, depose and say that (I am)(we are) partners of the hereinafter named partnership, and as such, have been authorized to file this application; and that said partnership is the owner tenant of the property described herein which is the application. (Name of Partnership) By By % % Sworn to and subscribed to before me this _____ day of ___________, ______. By By % % Notary Public: Commission Expires: ***************************************************************************************************************************************************** ATTORNEY AFFIDAVIT I, , being first duly sworn, depose and say that I am a State of Florida Attorney at Law, and I am the Attorney for the Owner of the property described and which is the application. Signature Sworn to and subscribed to before me Notary Public: this _____ day of ___________, ______. Commission Expires _____________________ American LegalNet, Inc. www.FormsWorkFlow.com OWNERSHIP AFFIDAVIT FOR CORPORATION STATE OF _______________________ COUNTY OF _____________________ Before me, the undersigned authority, personally appeared ______________________ hereinafter the Affiant(s), who being first duly sworn by me, on oath, deposes and says: 1. Affiant is the president, vice-president or CEO of the Corporation, with the following address: ____________________________________________________________ ___________________________________________________________________ 2. The Corporation owns the property which is the subject of the application. 3. The subject property is legally described as: ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________________ 4. Affiant is legally authorized to file this application. 5. Affiant understands this affidavit is subject to the penalties of law for perjury and the possibility of voiding any zoning approval granted. Witnesses: ____________________________________ Signature ________________________ Affiant’s signature ____________________________________ Print Name ________________________ Print Name ____________________________________ Signature ___________________________________ Print Name Sworn to and subscribed before me on the _________ day of _________________ 20_____. Affiant is personally known to me [ identification. ] or has produced _____________________________ as Notary: __________________________________ (Stamp/Seal) Commission Expires: _______________________ [L:forms/afficorp.sam (8/07)] American LegalNet, Inc. www.FormsWorkFlow.com OWNERSHIP AFFIDAVIT FOR INDIVIDUAL STATE OF _______________________ COUNTY OF _____________________ Before me, the undersigned authority, personally appeared_______________________, hereinafter the Affiant, who being first duly sworn by me, on oath, deposes and says: 1. Affiant is the fee owner of the property that is the subject of the application. 2. The subject property is legally described as: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 3. Affiant understands this affidavit is subject to the penalties of law for perjury and the possibility of voiding any zoning approval granted. Witnesses: ____________________________________ Signature ________________________ Affiant’s signature ____________________________________ Print Name ________________________ Print Name ___________________________________ Signature ___________________________________ Print Name Sworn to and subscribed before me on the ______ day of _______________________, 20____ Affiant is personally known to me [ identification ] or has produced ______________________________as Notary: __________________________________ (Stamp/Seal) Commission Expires: _______________________ [L:forms/afficorp.sam (8/07)] American LegalNet, Inc. www.FormsWorkFlow.com DISCLOSURE OF INTEREST* If a CORPORATION owns or leases the subject property, list principal stockholders and percent of stock owned by each. [Note: Where principal officers or stockholders consist of other corporation(s), trust(s), partnership(s) or other similar entities, further disclosure shall be made to identify the natural persons having the ultimate ownership interest]. CORPORATION NAME: ____________________________ NAME AND ADDRESS Percentage of Stock ______________ ______________ _____________________________________ ______________ _____________________________________ ______________ If a TRUST or ESTATE owns or leases the subject property, list the trust beneficiaries and the percent of interest held by each. [Note: Where beneficiaries are other than natural persons, further disclosure shall be made to identify the natural persons having the ultimate ownership interest]. TRUST/ESTATE NAME ____________________________________ NAME AND ADDRESS Percentage of Interest _____________________________________ _________________ _____________________________________ _________________ _____________________________________ _________________ _____________________________________ _________________ _____________________________________ _________________ _____________________________________ _________________ If a PARTNERSHIP owns or leases the subject property, list the principals including general and limited partners. [Note: Where the partner(s) consist of another partnership(s), corporation(s), trust(s) or other similar entities, further disclosure shall be made to identify the natural persons having the ultimate ownership interests]. PARTNERSHIP OR LIMITED PARTNERSHIP NAME: ____________________ NAME AND ADDRESS Percentage of Ownership ____________________________________ _______________ ____________________________________ _______________ ____________________________________ _______________ ____________________________________ _______________ ____________________________________ _______________ If there is a CONTRACT FOR PURCHASE, by a Corporation, Trust or Partnership list purchasers below, including principal officers, stockholders, beneficiaries or partners. [Note: Where principal officers, stockholders, beneficiaries or partners consist of other corporations, American LegalNet, Inc. www.FormsWorkFlow.com trusts, partnerships or other similar entities, further disclosure shall be made to identify natural persons having the ultimate ownership interests]. NAME OF PURCHASER: ____________________________________ NAME, ADDRESS AND OFFICE (if applicable) Percentage of Interest _____________________________________ __________________ _____________________________________ __________________ _____________________________________ __________________ _____________________________________ __________________ _____________________________________ __________________ Date of contract: _______________________ If any contingency clause or contract terms involve additional parties, list all individuals or officers, if a corporation, partnership or trust. ________________________________ _______________________________ ________________________________ _______________________________ ________________________________ _______________________________ ________________________________ _______________________________ ________________________________ _______________________________ NOTICE: For any changes of ownership or changes in purchase contracts after the date of the application, but prior to the date of zoning approval, a supplemental disclosure of interest is required. The above is a full disclosure of all parties of interest in this application to the best of my knowledge and belief. Signature: ____________________________________________ (Applicant) Sworn to and subscribed before me this ____________ day of ______________________, 20________. Affiant is personally known to me [ ] or has produced ___________________________ as identification. _______________________________ (Notary Public) My commission expires: ____________ *Disclosure shall not be required of: 1) any entity, the equity interests in which are regularly traded on an established securities market in the United States or another country; or 2) pension funds or pension trusts of more than five thousand (5,000) ownership interests; or 3) any entity where ownership interests are held in a partnership, corporation or trust consisting of more than five thousand (5,000) separate interests, including all interests at every level of ownership and where no one (1) person or entity holds more than a total of five per cent (5%) of the ownership interest in the partnership, corporation or trust. Entities whose ownership interests are held in a partnership, corporation, or trust consisting of more than five thousand (5,000) separate interests, including all interests at every level of ownership, shall only be required to disclose those ownership interest which exceed five (5) percent of the ownership interest in the partnership, corporation or trust. American LegalNet, Inc. www.FormsWorkFlow.com