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RECEIPT
CITY OF FORT COLLINS
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. COLLEGE AVE
970.221.6760
PO BOX 580
970.224.6134 - fax
Application: PDP120014
Application Type: Planning/Project Development Plan/NA/NA
Address: FORT COLLINS, CO
Receipt No. 179408
Payment Method Ref Number Amount Paid Payment Date Cashier ID Received Comments
Planning Fees
5879.00, APO
label fee
136.50,
Transportation
Development
Fee 3670 Paid
Check 39036/507261 $9,735.50 04/25/2012 ALOMMEL by PDC
Midwest, Inc.
on ch#39036.
Sign posting
fee 50.00 Paid
by Westrian
Group, Inc.
ch#507261
Project
Description:
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Cftyof Transportation Development Review Fee Dare ceiv _Poi -5�-ors /off
/� Collins Tota Amount Paid dd
VDT Project Name:�:.✓C-�� irr,n��eTy
Project Location: 1,n sg- �� l (,� Datef
Type of Submittal
Please indicate the type of application submitted by checking the box
preceding the appropriate request(s).
❑ Overall Development Plan (ODP)
❑ Final Development Plan (FDP)
This fee includes 2 rounds of review
❑ Additional round of review
❑ Annexation $20 X
❑ Minor Amendment
❑ Major Amendment
❑ Re -zone
Fee structure amount due
$500 each
$1000 each
$ 500 each
Foot Notes:
When a development project involves a change of use for a
building, the charge per square foot shall apply to the portion of
the overall building size for which the change of use is proposed,
provided that the new use generates more traffic than the existing
use, as determined by the current Institute of Transportation
Engineers Trip Generation. If the new use does not generate more
traffic than the existing use then the charge per square foot for
shall apply only to the net additional building size (if any).
acres = _ + $250 = These fees do not include the cost of filing fees for the recording of
$250 each the Development Agreement. When a Development Agreement or
Amendment Agreement is entered into the Developer shall be
$2,500 each responsible for the cost of recording the document. Said filing fees
$200 each shall be calculated and provided when the signed document is
returned to the City for signatures and filing.
❑ Modification to Land Use Code S200 each
❑ Wireless Telecommunication Equipment (WTE) $65 each
❑ Road Projects acres (of roadway) X $250 =
❑ Vacation of Easement(s) '•• # of vacations _ X $400 =
❑ Vacation of Right(s)-of--Way *** # of vacations _ X $800 =
ElDedication of Easement(s) and/or Right(s)-of--Way ***
# of dedications _ X $250 =
❑ Project Development Plan (PDP) or Basic Development Review Project
requiring Transportation Services Review and/or utility plan review. This fee
includes 3 rounds of review.
Detached Single Family $160 per unit
# of units X $160 =
Multifamily or other residential units $115 per unit
# of units X $115 =
Commercial, Industrial, Retail, and/or Non residential
building square footage $0.25 per square foot
sgftX$0.25=
Size of the development (area being platted or if not being
platted size of parcel accompanying all dev5lypment�)
improvements) $250 per acre acres X $ 250 =
Project fee $2,000 each sum
Total of above amounts ;e /! J .
If this fee amount exceeds $30,000 then the fee amount shall be aad--jjuusstteedd with
the following formula:
$30,000 + /, (the amount over 30,000 _
The maximum fee for any residential ONLY project shall be $500 per
residential unit. This check should be used to verify the fee amount (does not
apply to mixed -use developments). PDP fee shall be the lesser of this amount
or the above calculated amount.
# of residential units X $500 =
Reduction for affordable housing - a copy of the City letter certifying/
authorizing the affordable housing shall be provided with this application.
Amount of reduction to be applied
Total owed for PDPA 3 i�� 7 r
cc: Christie White, Engineering
Development Review Engineering
*** This fee does not include the cost of filing fees. Filing
fees shall be determined at the time of final document
submittal and will be required prior to filing.
General Information:
Owners Name(s): 1p ¢c
Street address: 67 3:7 Ll(- !t/G Sip
�6e10& z3cics
City/State/Zip: o2lV
Telephone:1/4-266�0'1Fax:
f�
Applicants/ Consultants Firm Name:
Contact: it_C �i✓\
Street address: lv�
t
City/State/Zip: - 7✓�A
Telephone.,�0.95-05 5�� Fax:
Certification:
By signing this permit I acknowledge that I am acting with
the knowledge, consent, and authority of the owners of the
property (including all owners having legal or equitable
interest in the real property, as defined in Section 1-2 of the
City Code; and including common areas legally connected
to or associated with the property which is the subject of
this application) without whose consent and authority the
requested action could not lawfully be accomplished.
Pursuant to said authority, I hereby permit City officials to
enter upon the property for purposes of inspection.
Name (please print):
Signature:
Telephone: �o�
City Of Development Review Guide —STEP 3 of 8
F6rt Collins SUBMITTAL CHECKLIST:
SUBDIVISION PLAT (PDP)
The following information is required to be submitted with all applications, unless waived by
staff. Any item waived must be dated and initialed by a planner with the City of Fort Collins
Community Development and Neighborhood Services Department.
T Application form, filing fee (plus .75 cents for each APO label), and sign posting fee. Application Forrn.Ddf
Transportation Development Review Fee - please contact Engineering at 221-6605 for information.
TDR Fees and ADplication.Ddf
tl Three (3) lists of names and addresses of all owners of record of real property within at least 800' of
property lines for the parcel of land for which the project is proposed, exclusive of public right-of-way. Two
(2) lists ty ed on mailing labels (33 names per sheet) and the other list on a reproducible copy of those
labels. s�c� (zoo
Statement of planning objectives � /_ op�.�Z ie�s)
4S A. 6OLC�q
❑ Copy of applicable conceptual letter and response letter ex0aining how issues have been addressed
Subdivision Plat (2{3copies 24" x 36"'-,fo+lld'ed).
Drainage Report (4 copies).
❑ Transportation Impact Analysis (TIA) (6 copies).
❑ Utility Plans (existing and proposed utility systems) (13 copies 24" x 36" - unfolded).
❑ Requirements for utility plans checklist (1 copy). Utility Plans Checkiist.Ddf
�\ .3 3 ❑ Street cross section schematics (if not included in utility plans) (8 copies -folded).
❑ Other information Director may require:
- Letters of intent for any easements
- Soils Report (2 copies)
'This document is eant to be used as a checklist only. For a more detailed list and explanation of each of
these items, please see the handout: "Submittal Requirements: Subdivision Plat (PDP)'
Community Development & Neighborhood Services - 281 N College Ave - Fort Collins, CO 80522-0580
City of
wort Collins
DEVELOPMENT REVIEW:
APPLICATION FORM
For Office Use Only
Date Submitted �"as _i� Current Planning File Planner
•c
Project Information
Site/Area Information
Project Name: Brookdale Senior LlviW Community
Residential Area: 290,669 _Sq. Ft. 6.66 Acres
Project Description (Choose type o/request from the&t on the back):
Commercial Area: _ Sq. Ft. Acres
Industrial Area: _ Sq. Ft. Acres
Mixed Use Area: _Sq. Ft. Acres
Right of Way Area: Sq. Ft. Acres
Parking and Drive Area: Sq. Ft. Acres
Stormwater Detention Are q. Ft, Acres
ct Address: 1. su nln9 Heuea PUD and La +.
Location DMemory
Wovenhearts Memory Gam-1002/1006 Rule Ddva Fort Collins, Co
Care- IW2 / Fa
Landscape Area: Sq. Ft. Acres
Open/Other Areas: Sq. Ft. Acres
Gross Area: Sq. Ft. Acres
Major Cross Streets: LemayAvenue anal Rule Drive
Zone District: MMR
Floor Area Ratio:
Parcel Number: 9601156MI 191101164001
Gross Density: Net Density
Building/Unit Information
Owner Information
Residential: a Square Feet
Name: Brookdale Senior Living Communlbes, Inc., a Delaware Company
Address: 6737 W. Washington Sheet, sui+a 2300
Commercial: s. D 37 Square Feet
Industrial: Square Feet
City. Milwaukee State: wl Zip: SM14
Building Floor Area Ratio:
Phone: 414-016-6410 Email:
Platted Area: 6.67 acres
Number of Units:
,Applicant Information
Single Family Attached: —Single Family Detached:
Name: Edwardaohns�on
Organization Name: PDCMidwesl.Inc
Two Famify: Multi-Family:��
Contact: Edward Johnson
Address: 1130 James Dave score mfi
Dates:
City Headland State: wl Zip: 53029
Conceptual Review Meeting Date J° 6, 2011
Phone: 262-5e3-5276 Email: elohnson(ilipdcmldwest.cam
Neighborhood Meeting Date
Preferred Method of Contact: email
Hearing Type=
II ,,
CERTIFICATION
I certify the information and exhibits submitted are true and correct to the best of my knowledge and that in filing this application, I am acting with
the knowledge, consent, and authority of the owners of the real property, as those terms are defined in Section 1-2 of the City Code (including
common areas legally connected to or associated with the property which is the subject of this application) without whose consent and authority the
requested action could not lawfully be accomplished. Pursuant to said authority, I hereby permit City officials to enter upon the property for the
purpose of inspection, and if necessary, for posting of public notice on the property.
Name (Please PRINT): Edward Johnsen
Address: 1130 James Deve Suke 1 W HearOand W153029
Telephone: 262.563-5279
Signature: (and title showi u orit to sign, if applicable)
b CERTIFICATIONMUSTBE SIGNED.
1i
Community Development & Neighborhood Services — 281 N College Ave — Fort Collins, CO 80522-0580