PUBLIC SCHOOL IMPACT APPLICATION
Growth Management Section
Facility Planning and Real Estate Department
School Board Number
The School Board of Broward County, Florida
600 SE 3rd Avenue, 8th Floor, Fort Lauderdale, FL 33301; Phone: 754-321-2177, Fax: 754-321-2179
www.browardschools.com
Site Plan
County Project Number
City Project Number
Project Name
APPLICATION TYPE
GENERAL PROJECT INFORMATION
Has this project been previously submitted (since Feb. 01, 2008) ?
Application Fee Amount Due/Paid* Is proof of Payment attached?
PROJECT LOCATION AND SIZE
Section
Township
Range
General location of the project Side of
at/between and
Area Acreage
Jurisdiction
If yes, provide the SBBC Number
DRI
Plat
Flex/Reserve Allocation
Rezoning
Land Use
FOR INTERNAL USE ONLY
Check No.
* Make check payable to "School Board of Broward County." No cash will be accepted.
APPLICANT INFORMATION
Owner's Name
Phone
Address City
State
Zip
Developer/Agent
Zip
State
CityAddress
Phone
Agent's E-mail
Fax Number
DEVELOPMENT DETAILS
Land Use Designation
Existing
Proposed
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Form No. 4726 03/09
Existing
Proposed
Zoning Designation
PERMITTED PROPOSED
Residential
Type
Total
Units
Built
Units
Bedroom Mix
Un-built
Units
Bedroom Mix
Residential
Type
Number
of Units
Bedroom Mix
Single Family
_____3 BR or Less
_______4 BR or >
_____3 BR or Less
_______4 BR or >
Single Family
_____3 BR or Less
_______4 BR or >
Townhouse/
Duplex/ Villa
_____1 BR or Less
__2 BR__3 BR or >
_____1 BR or Less
__2 BR__3 BR or >
Townhouse/
Duplex/ Villa
_____1 BR or Less
__2 BR__3 BR or >
Garden
Apartment
_____1 BR or Less
__2 BR__3 BR or >
_____1 BR or Less
__2 BR__3 BR or >
Garden
Apartment
_____1 BR or Less
__2 BR__3 BR or >
Mid Rise Mid Rise
High Rise High Rise
Mobile Home
____2 BR or Less
_______3 BR or >
____2 BR or Less
_______3 BR or >
Mobile Home
____2 BR or Less
_______3 BR or >
Total Total
Does this project include a non-residential development?
If yes, please describe other proposed uses
VESTED RIGHTS/EXEMPTION INFORMATION
Amount of Vested/Exempt development (including number of units, type, and bedroom mix)
Exemption Criteria
(check any/all as applicable)
Vesting Criteria
(check any/all as applicable)
Associated
Application Number
_______ Generates less than one student*
____ Located within previously approved plan amendment or
rezoning with a valid mitigation agreement with the School
Board through an executed and recorded DRC or Tri-Party*
______ Age restricted to persons 18 and over*
____ Obtained site plan final approval prior to February
1, 2008*
__________ Statutory exemption*
____________ Applicable Statute*
_____ Site plan located within a plat for which school
impacts have been satisfied*
_____________ Site Plan located within a plat with a valid final SCAD letter*
Associated Plat
Number: __________
* Supporting documentation is required
Signature of Applicant/Agent: _______________________________________ Date:_______________________________
Please attach a survey of the project site
NOTE: 30-Day review period only commences upon a determination of completeness by School District Staff. Applicant submitting a plat application must include an official letter
containing plat name and municipal project number and must indicate that the plat has been approved or accepted by the municipality
ALL APPLICANTS MUST SUBMIT THE APPLICATION TO THE 8th FLOOR
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Form No. 4726 03/09