HomeMy WebLinkAboutFee Calculation WorksheetFEE CALCULATION WORKSHEET
SITE DEVELOPMENT PLANS — Planning Division
Application Type:
Minor Site Plan
Supplemental Application Package No.:
(Please provide separate fee calculation worksheet for each application type)
❑ BASE REVIEW FEE:
$ 1,700 (A)
❑ CONCURRENCY FEE:
$ 500 (B)
❑ ERD REVIEW FEE:
$ 100 (C)
❑ UTILITIES
$ 50
❑ PER ACREAGE CHARGE:
$ 30 (D)
❑ RESUBMITTAL FEE: (if applicable)
$ (E)
❑ OTHER
$
SUBTOTAL OF BASIC FEES:
$ 2,380
❑ PRE -APPLICATION MEETING FEE: (F) $( 250 ) deduction
Receipt No. of Payment:
Date of Pre App:
BALANCE OF FEES DUE: $ 1,773.00
SEPARATE CHECK FOR TRAFFIC IMPACT STUDY — Ordinance No. 06-047; amending Chapter 5.11.01
of the St. Lucie County Land Development Code
❑ $950.00 — Methodology Meeting (H) (If Applicable)
• Additional fees will be due if a 3rd party traffic study review is needed. These services will be invoiced to
applicant upon receipt of quote of services from 31d party.
• Please note: For all projects requiring public notice, you will be invoiced by St. Lucie County Planning
Division. Refer to `Public Procedures".
• Other fees may be applicable by other external reviewing agencies; i.e. Fire District and proof of payment
will be required prior to project approval. Pre -Application Meeting uest
Mr. Gabriel Takayama
Applicant Name (Printed) gnatur f appf ant
INTAKE REVIEWER -SIGNATURE
VERIFIED BY - SIGNATURE
File #: Receipt #:
Page 2 of 6
Revised March 15, 2016
(For office use only)
DATE
DATE
Ind
SPECIAL NOTICE
(PLEASE READ BEFORE SIGNING ACKNOWLEDGMENTS BELOW)
Submission of this application does not constitute the granting of approval. All appropriate requirements must
be met prior to this project being presented for approval to the appropriate authority. St. Lucie County reserves
the right to request additional information to ensure a complete review of this project.
ACKNOWLEDGMENTS
Applicant Information (Property Developer): Aaent Information:
Business Name: Panelli Fort Pierce, LLC Business Name: MBV Engineering, Inc.
Name: Mr. Gabriel Takayama Name: Rebecca Grohall AICP
Address: 6499 Powerline Road, Suite 101 Address: 1835 20th Street
Fort Lauderdale, FL 33309 Vero Beach, FL 32960
(Please use an address that can accept overnight (Please use an address that can accept overnight
packages) packages)
Phone: 786-250-2568 Phone: 772-569-0035
Fax: Fax: 772-778-3617
Email: gabriel@wolflube.com Email: rebeccag@mbveng.com
Please note: both applicant and agent will receive all official correspondence on this project.
Property Owner Information
This application and any application supplement will not be considered complete without the notarized
signature of all property owners of record, which shall serve as an acknowledgment of the submittal of this
application for approval. The property owner's signature below shall also serve as authorization for the above
applicant or agent to act on behalf of said property owner.
v144q11"p4,vr7i, • Mr. Gabriel Takayama
perty OWner signature Propedy Owner Name (Printed)
ailing Address: '6499 Powerline Road, Suite 101 Phone: 786-250-5268
If more than one owner, please submit additional
Fort Lauderdale, FL 33309 pages
STATE OF COUNTY OF r /
The foregoing instrument 1
��nt was acknowledged before me this 0��i day of& vgat enn 20 90
by 6-J.Ve l /e, & aysa who is personally known to me or who has produced
ey / as
identification.
``//
/NBh ✓ ��r� arPN
Signature o o ary Type or Print Name of NoAry
GG 416 ` elf Commission Number (Seal)
NANCYCORCORAN
.,. MY COMMISSION SGG145449
d EXPIRES: November4,2021
Page 5 of 6 Bonded Thru Notary PuNk Underwriters
Revised March 15, 2016