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Community Development Department • Planning Division Project Project Case No.*: Submittal Date*: Fee*: *To be completed by City staff Type of Request: Conceptual Review Comprehensive Plan Amendment Planned Unit Development Plan Planned Unit Development Amendment Rezoning ROW / Easement Vacation / Easement Grant Revocable Permit Site Development Plan Site Development Plan Amendment Subdivision - Final Plat / Replat Subdivision - Preliminary Plat Subdivision - Minor Plat Use by Special Review (Various) Urban Renewal Site Plan Vesting Rights Other Summary of Request: Project Address or Parcel IDs: Applicant / Developer: Company: Contact: Address: Phone: E-Mail: Property Owner: (per current title policy) Company: Contact: Address: Phone: E-Mail: Planner/Architect/Engineer: Company: Contact: Address: Phone: E-Mail: Project Information: Legal Description: (attach additional sheet if necessary) Subdivision: Lot(s): Blk(s): Proposed Subdivision Name: Est. Project Land Valuation: Est. New Construction Valuation: Development Statistics: (do not leave any blanks - use n/a) Current Zoning: Proposed Zoning: (i.e. A-1, E-1, R-1, B-1, I-1, PUD, etc.) Current Land Use: Proposed Land Use: Size of Property: Flood zone(s): Proposed residential lots: Single-family lots: Townhome units: Condo units: Apartment units: Proposed commercial: (sq.ft.) Proposed industrial: (sq.ft.) Proposed system: (check one - if applicable) City Sewer Lift Station OWTS/Septic As owner of the aforementioned property, I hereby consent to the submission of this Application for Development Review and authorize the applicant to act on my behalf with regard to this application. Owner: Signature: One DesCombes Drive • Broomfield, Colorado • 80020 • [PHONE REDACTED] • www.broomfield.org SIGN ---PAGE BREAK--- Community Development Department • Planning Division Applicants must submit the following information in order for the application to be deemed complete and accepted. An application missing any of the items below will be considered incomplete and cannot be processed until the missing items are provided. All information must be submitted following the specifications listed in the Submittal Guidelines document. Pre-Application Meeting - Date: Planner: (It is highly recommended to meet with a member of the Planning staff at least two weeks prior to plan submittal. Use this Pre-Application Meeting Request form and submit to [EMAIL REDACTED]. The meeting provides an opportunity for the applicant to discuss the development proposal and receive preliminary comments and direction from various city department representatives.) Fee for Processing, Noticing, and Recording $200 = less than 10 acres; or $500 = more than 10 acres. $100 = notice and publication fee. (required) $50 = optional fee for address records search service to facilitate public notification to surrounding properties within 500’ of the subject property. (Broomfield properties only) Broomfield accepts payment of fees by credit card* (after submitting your application please call: [PHONE REDACTED]) or check (made payable to: The City and County of Broomfield). Please include a reference to the project name or property address in the subject line of the check if sending prior to the issuance of a case number by Broomfield. *Note that there is a processing fee of 2.65% for payments made by credit cards. APPLICATION SUBMITTAL DOCUMENTS: Submit email with a pdf of all items listed on the checklist below to [EMAIL REDACTED]. Dropbox or other file sharing tools may be used if needed. All files must be named and organized in accordance with the Submittal Guidelines. Application Packet (mm-dd-yyyy) (Development Review Application and Checklist) Items waived by city staff must include the authorizing staff member’s name next to the checkbox. Project Description (mm-dd-yyyy) (separate write-up in letter format) (For residential projects include: minimum, maximum, and average lot sizes and unit sizes; and density) Proof of Ownership (mm-dd-yyyy) (Title Commitment current within 60 days from date of application) Include electronic link with live links to exceptions Mineral Estates Notification (mm-dd-yyyy) - Signed by Owner (form) Preliminary Plat (mm-dd-yyyy) (BMC Chapter 16-16) Include applicable certification blocks, development tables, and standard notes. AutoCad Files (AutoCad for all sheets of preliminary plat must be submitted matching the PDF sets in AutoCAD v.2017 or older) One DesCombes Drive • Broomfield, Colorado • 80020 • [PHONE REDACTED] • www.broomfield.org ---PAGE BREAK--- Development Review Application Packet Preliminary Plat Page 2 of 2 (mm-dd-yyyy) - other requirement as requested PRELIMINARY REPORTS AND STUDIES: (separate electronic folder to include all items required below) Utility Report (mm-dd-yyyy) Drainage Report (mm-dd-yyyy) Traffic Analysis Report (mm-dd-yyyy) Geotechnical Study (mm-dd-yyyy) (including Earthen Cut and Fill Investigation Report) Environmental Assessment & Open Lands/Trails Analysis (mm-dd-yyyy) (guidelines) Oil and Gas Well Abandonment Report (mm-dd-yyyy) *Only if there are plugged/abandoned wells on site or within 200 feet of site (instructions) (mm-dd-yyyy) - other report or study as requested To be completed by Planning: INCOMPLETE APPLICATION AND APPLICANT INFORMED ON: (date) APPLICATION COMPLETE AND ACCEPTED ON: (date) City and County of Broomfield • Community Development Department • Planning Division One DesCombes Drive • Broomfield, Colorado • 80020 • [PHONE REDACTED] • www.broomfield.org