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Application Form Last Updated: February 6 2014
- REC5.IVE
Special Use Permit JUN 2 4 2016
Application Form for a Proposed Use CITY OFAMES,IOWA
in a Residential Zone DEPT.OF PLANNING&HOUSING
(This form must be filled out completely before your application will be accepted.)
1. Property Address for this Special Use Permit: 03-805 Dickinson Ave,Ames
2. I (We) the undersigned, do hereby respectfully request the Ames Zoning Board of
Adjustment to ,grant a Special Use Permit for a proposed use in a `Residential Zone" to
allow group home residential living
at the property address listed above.
DAUNTLESS SD 1ST ADD LOT:15 AMES
3. Legal Description (attach, if lengthy):
4. Property Owner: Colin and Kimberly Hurd
Business:
101 DIAMOND ST,Ames,IA 50010
Address:
(Street) (City) (State) (Zip)
Telephone: 15-321-2055-mobile
(Home) Business) (Fax)
5. Applicant:
Assault Care Center Extending Shelter&Support
Business:
Address: rox 1429 Ames IA 50014
(Street) (City) (State) (Zip)
Telephone: 1
515-292-0500 515-292-0505
(Home) (Business) (Fax)
ngie Schreck
6. Contact Person:
�irector of ACCESS
Business:
ox 1429 Ames IA 50014
Address.
(Street) (City) (State) (Zip)
Telephone: 641-373-0020-mobile
(Home) (Business) (Fax)
E-mail address: Vector@assaultcarecenter.org
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dotloop signature verification:
Application Form Last Updated: February 6, 2014
This Special Use Permit will not be granted unless sufficient facts are presented with
the application, and at the Planning and Zoning Commission and Zoning Board of
Adjustment meetings to support a finding that all the general and specific standards
for granting a Special Use Permit have been met.
Obtaining this Special Use Permit does not absolve the applicant from obtaining all other
applicable permits, such as Building Permits, IDOT access permits, etcetera.
I (JYe) certify that I (we) have submitted all the required information to apply for a Special Use
Permit and that the information is factual.
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Signed �� 05127/166:ry �J• OAF9-CACN Date:
.M 7 Property Owner(s)
Colin and Kimberly Hurd
Print Name
(1Vote: iVo other sigitature may be substituted for the Property Owner's Signature.)
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Application Form Last Updated: February 6, 2014
Special Use Permit
Supporting Information for a Proposed Use
in a Residential Zone
(This form must be filled out completely before your application will be accepted.)
The Zoning Board of Adjustment cannot approve a Special Use Permit unless all of the
"General Standards" and the "Residential Zone Standards" are met. In order to facilitate
review of this application for a Special Use Permit, the applicant must address each of the
"General Standards", set forth in Section 29.1503, and in addition, the "Residential Zone
Standards", set forth in Section 29.1503(4)(b) of the Zoning Ordinance.
(Note: The applicant's explanation of how the request meets each standard may be attached
on a separate sheet if sufficient space is not provided.)
1. General Standards. The Planning and Zoning Commission and the Zoning Board of
Adjustment shall review each application for the purpose of determining that each proposed
use meets the following "General Standards", set forth in 29.1503(4)(a), and in addition,
shall find adequate evidence that each use in its proposed location will:
(a) Be harmonious with and in accordance with the general principles and
proposals of the Land Use Policy Plan (LUPP).
Explain how the request meets this standard.
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(b) Be designed, constructed, operated and maintained so as to be
harmonious in appearance with the existing or intended character of the
general vicinity and that such use will not change the essential character of
the area in which it is proposed.
Ex lain how the request meets this standard.
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Application Form Last Updated: February 6, 2014
(c) Not be hazardous or disturbing to existing or future uses in the same
general vicinity.
Explain how the request meets this standard.
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(d) Be served adequately by essential public facilities and services such as
highways, streets, police, fire protection, drainage structure, refuse
disposal, water and sewage facilities, and/or schools.
Explain how the request meets this standard.
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(e) Not create excessive additional requirements at public cost for public
facilities and services.
Explain how the request meets this standard.
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Application Form Last Updated: February 6, 2014
(� Not involve uses, activities, processes, materials, equipment or conditions
of operation that will be detrimental to any person, property or general
welfare by reason of excessive production of traffic, noise, smoke, fumes,
glare, or odors.
Ex in how the request meets this standard.
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(g) Be consistent with the intent and purpose of the Zone in which it is
proposed to locate such use.
Explain how the request meets this standard.
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Application Form Last Updated: February 6, 2014
2. Residential Zone Standards. The Planning and Zoning Commission and the Zoning Board
of Adjustment shall review each application for the purpose of determining that each
proposed use in a residential zone meets the "Residential Zone Standards", set forth in
29.1503(4)(b), which are listed below, and shall find adequate evidence that each use in its
proposed location will:
(a) Not create excessively higher levels of traffic than the predominant pattern
in the area and not create additional traffic from the proposed use that
would change the street classification and such traffic shall not lower the
level of service at area intersections.
Explain how the request meets this standard.
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(b) Not create a noticeably different travel pattern than the predominant
pattern in the area. Special attention must be shown to deliveries or
service trips in a residential zone that are different than the normal to and
from work travel pattern in the residential area.
Explain how the request meets this standard.
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Application Form Last Updated: February 6, 2014
(c) Not generate truck trips by trucks over 26,000 g.v.w. (gross vehicle weight)
to and from the site except for food delivery vehicles,waste collection
vehicles and moving vans.
Explain how the request meets this standard.
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(d) Not have noticeably different and disruptive hours of operation.
Explain how the request meets this standard.
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(e) Be sufficiently desirable for the entire community that the loss of
residential land is justifiable in relation to the benefit.
Explain how the request meets this standard. .
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Application Form Last Updated: February 6, 2014
(t) Be compatible in terms of structure placement, height, orientation, or scale
with the predominate building pattern in the area.
Explain how the request meets this standard.
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(g) Be located on the lot with a greater setback or with landscape buffering to
minimize the impact of the use on adjacent property.
Explain how the request meets this standard.
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(h) Be consistent with all other applicable standards in the zone. " �D
Explain how the request meets this standard.
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Application Form Last Updated: February 6, 2014
Special Use Permit
Site Development Plan Checklist for a Proposed Use
in a Residential Zone
(This form must be filled out completely before your application will be accepted.)
The applicant shall provide seven (7) copies of a Site Development Plan, which includes
the information described below, as set forth in Section 29.1502 of the Zoning Ordinance.
❑ Seven (7) copies of a Site Development Plan, drawn to scale on a sheet not to exceed 24" x
36", and one (1) reduced copy no larger than 11'xl7".
❑ The Site Development Plan must be prepared by a Civil Engineer, a Land Surveyor, a
Landscape Architect, or an Architect. The site plan must be certified as "substantially
correct" by a Professional Engineer, a Land Surveyor, a Landscape Architect, or an
Architect, licensed by the State of Iowa, showing the following information as of the date
of the application.
Note: With approval by City staffprior to submitting the Site Development Plan, it may be possible to
exclude some of the following items from the Site Development Plan. Please place a check mark in
the box in fYont of each item that is included as part of the application materials submitted for
approval.
❑ Name(s) and address(es) of the applicant(s).
❑ Name(s) and address(es) of the owner(s) of record of the property.
❑ Name and address of the person or firm preparing the site plan.
❑ Property address(es).
❑ Date of preparation.
❑ North Arrow.
❑ Scale: The scale shall not be less than V=10', and no greater than V=60% unless an
alternate scale is approved by the Director of the Dept. of Planning and Housing.
❑ Legal Description.
❑ Dimensions of the present lot and lot area, to the nearest tenth of a foot.
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Application Form Last Updated: February 6, 2014
❑ Size and location of all existing and proposed buildings, additions, structures and uses,
including:
❑ Setback distance to property lines.
❑ Exact exterior dimensions of each building.
❑ Location of entrances.
❑ Number of dwelling units.
❑ Square footage of each type of use.
❑ Zoning designation of the property.
❑ Proposed use of the property in sufficient detail to determine code compliance.
❑ Existing and proposed location and size of sanitary sewer mains and service lines, or septic
tank and leaching field.
❑ Existing and proposed location and size of water mains, service lines and hydrants, and/or
water well.
❑ Existing and proposed location and size of electrical service (electrical riser diagram) and
the location of high pressure gas lines, high tension transmission lines, and telephone lines.
❑ Existing and proposed location and size of storm drainage facilities on the property and
adjacent to the property.
❑ Location, grade and dimensions of all existing paved surfaces and of all abutting streets.
❑ Existing and proposed location and dimensions of parking areas, individual parking spaces
and drive aisles, driveways, curb cuts, easements and rights-of-way, walkways, transit
stops, bicycle parking areas, loading areas, dividers, curbs, islands, and other parking and
drive improvements.
If the project is located along U.S. Highway 69, access to U.S. 69 shall be reviewed by the
L D.O.T. and a meeting shall be held that includes I.D.O.T. staff, the City traffic engineer,
other appropriate City staff, the developer, and the developer's plan preparer to agree on
access prior to the submittal of the site plan.
❑ Existing and proposed contours at 2-foot intervals, based on City datum, when an
application pertains to any new permanent detached building or structure (principal or
accessory).
❑ Location of existing and proposed outdoor trash and dumpster areas and methods for
screening such areas.
❑ Location and type of all existing and proposed signs.
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Application Form Last Updated: February 6, 2014
❑ Evidence that the proposed work or activity will comply with the Outdoor Lighting Code.
Specifically, the application shall include:
❑ Plans indicating the location on the premises, and the type of illuminating devices,
fixtures, lamps, supports, reflectors and other devices;
❑ A detailed description of the illuminating devices, fixtures, lamps, supports, reflectors,
and other devices. The description shall include manufacturer's catalog cuts and
drawings, including sections when requested; and
❑ Photometric data, such as that furnished by manufacturers, showing the angle of cut off
or light emissions.
❑ Location of waterbodies, watercourses, swamps and flood-prone areas with delineated
channel encroachment lines, wetland boundary lines, 100-year flood plain boundary line,
and floodway boundary line.
❑ When an application is located in a flood-prone area include existing and proposed site
grades, contours and elevations, base flood elevation data, top-of-foundation elevations,
finished floor elevations, and any proposed watercourse relocation.
❑ When an application for development involves 0.5 acres, or more, of cumulative disturbed
area(s), a Sediment Erosion Control Plan shall be submitted. However, such a Plan may be
required for applications with disturbed land of less than 0.5 acres, if deemed necessary by
the Planning Director.
❑ Location of natural features including: existing trees, rock outcrops and landslide areas.
❑ Storm water management plan, including storm water calculations supporting the design.
Such plan shall show grades and/or elevations, direction of surface flow, detention and/or
retention areas, outlet control structures and devices.
❑ A landscape plan showing:
❑ The location of plants.
❑ A plant list that includes:
❑ The plant species;
❑ The quantity of each type of plant; and,
❑ The size of each plant at the time of planting.
❑ The location of fences and walls.
❑ Traffic impact studies, soil tests, utility capacity analysis, and other similar information if
deemed necessary by the Department of Planning and Housing to determine the feasibility
of the proposed development.
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Application Form Last Updated: February 6, 2014
❑ Two (2) copies of architectural drawings of all new buildings or structures, or alterations, at a
scale not to exceed 1"=8% showing the following information:
❑ Name(s) of the applicant(s) and the owner(s) of record;
❑ Legal description and street address of the property;
❑ Numerical scale and date;
❑ All exterior wall elevations, indicating floor heights, overall building height and
fenestration; and,
❑ Building floor plans indicating existing and proposed usage, interior floor area and/or
patron floor area.
❑ For Village Residential projects, Suburban Residential projects, or Planned Residence
District projects that are to develop in phases, the applicant shall provide a phasing plan
indicating areas to be developed in each phase and the time frame for the development of
each phase.
❑ A note to be placed on all site plans to read as follows: "All construction materials,
dumpsters, detached trailers, or similar items are prohibited on public streets or within the
public right-of-way."
❑ Size of electrical service and one line drawing of the metering and electrical service.
❑ Number of meters at each location.
❑ Preferred voltage required for the building.
❑ Preferred location of the electrical service.
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dotloop signature verification:
Application Form Last Updated: February 6, 2014
Special Use Permit
(Proposed Use in a Residential Zone)
Permission to Place a "Zoning Action Pending" Sign
on Private Pi-opehty
(This form must be filled out completely before your application will be accepted.)
Section 29.1500(2)(d)(iii) of the Zoning Ordinance, requires that notice shall be posted by the
City on the subject property. One notice sign shall be posted for each property. Required
signs shall be posted along the perimeter of the subject property in locations that are highly
visible from adjacent public streets prior to the public hearing.
803-805 Dickinson Ave,Ames
The owner of property at hereby grants the City of Ames
permission to place "Zoning Action Pending"signs on the property for the purpose of informing
interested persons of the request for action by the City of Ames.
1 understand that the signs ivill be Placed on the property several clays prior to action on the request by
the Planning and Zoning Commission or the City Council, and nay remain on the property until the
request has been approved oi-denied by the Cit}l.
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Signed by: Date:
Property Owner
Colin and Kimberly Hurd
Print Name
(Note: No other signature may be substituted for the Property Owner's Signature.)
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Application Form Last Updated: February 6, 2014
Adjoining Property Owner Statement 0
(Completion of this form by the applicant is optional.)
To Whom It May Concern:
We, the undersigned, own property adjoining Ames, Iowa.
It is our understanding that has filed an
appeal with the Zoning Board of Adjustment to allow
As adjoining property owners, we would have no objections to the issuance of this building
permit for the purposes stated above.
NAME ADDRESS DATE
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BUILDING PHOTO AND SKETCH SHOWING EXTERIOR DIMENSIONS
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DATE OF INSPECTION —BY DATE OF PHOTO I�/AS
FOUNDATION FIRST FLOOR
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CONDOMINIUM CONCRETE BLOCK STONE CONCRETE p
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TOWNHOUSE,END TILE OR BRICK PILASTERS TOWNHOUSE,INSIDE C:1 2 3 4 5SINGLE FLOOR ELING GAMGE
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OVERALL CONDITION: 1 2 4 5 CLEARANCE 9G� CARPETING ✓ ( INls 1s7,Z AYEAR BUILT 997- 199
FINISH TYPE PAMT �W6 H DW M/A,-I-•5 C: 1 2 3 5 O: 1 2 3 4 5 C: 1 2 3 4 5
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21h STORY FINISHED SETTLEMENT ND FLOOR
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Jim
April 14,2016.
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