SOUTH FLORIDA REGIONAL PLANNING COUNCIL

REQUEST FOR DRI/FQD APPLICATION FOR DEVELOPMENT APPROVAL (ADA)

1. Applicant (Name, Address, Telephone)

2. Authorized Agent (Name, Address, Telephone)

3. Name of Project

4. Location of Project

Sections: Township: Range:

County/Municipality:

General Location:

5. The undersigned hereby requests a pre-application conference with the South Florida Regional Planning Council regarding the proposed development plans for the above referenced property. The undersigned understands that the $15,000.00 deposit accompanying this request is an initial fee and that the submittal for review of this application for development approval or development approval of a substantial deviation shall be accompanied by an additional $20,000.00 deposit pursuant to Rule 9J-2.0252(2)(a), and by this reference made a part hereof.

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Date Signature of Applicant or Authorized Agent

Receipt of Application for Development Approval and review fee:

_____________________ ___________________________________________

Date Received South Florida Regional Planning Council