HomeMy WebLinkAboutHARRISONS ADDITION BLOCK 116 LOT 11 632 SOUTH MASON STREET THE MAYOR OF OLD TOWN - Filed MA-MINOR AMENDMENT - 2011-04-20 (2)�of
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Minor Amendment Application Form
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Project Name: The Mayor of Old Town: Minor Amendment
Project Location (Street Address): 632 So. Mason St.
Legal Description: South 37-1/2' of Lot 11, Block 116, Harrison Addition
Minor Amendment Fee: $192.00
General Information: List all property owners having a legal/equitable interest in the property (Attach separate sheets if necessary).
Owner's Name (s): Rodney G. Clough
Street Address: 413 South Howes Street Unit 2N City/State/Zip: Fort Collins, CO 80525
Telephone:
Fax:
Applicant's/Consultant's Name: Kevin and Barb Bolin
Street Address: 411 N. Pitkin Street
Telephone: (970) 310-6171
Fax:
Name of firm:
City/State/Zip: Fort Collins, CO 80521
Email: Barb.bolin@gmail.com
SUBMITTAL REQUIREMENTS:
1) Six (6) copies of RECORDED plan (i.e. site, landscape, elevation, etc. - whichever is being altered) on
24" x 36" size (usually available at the Technical Services Department at 281 N. College) — RED -LINE
THE CHANGES ON the six plans or provide six copies of revised drawings showing the changes in
addition to the six originals;
2) Completed and signed application form; and
3) Application fee of $192.00.
MINOR AMENDMENT
Detailed description -of the change and reason(s) for the request: Request for Change of Use from
Retail -Furniture Store to a Restaurant. There is no current Site Plan on record; initial site plan included with
application.
Land Planner: Deanne Frederickson (970) 674-3323.
CERTIFICATION
I certify the information and exhibits submitted are true and correct to the best of my knowledge and that in filing this application, I am acting with
the knowledge, consent, and authority of the owners of the property (including all owners having a legal or equitable interest in the real property, as
defined in Section 1-2 of the City Code; which is the subject of this application) without whose consent and authority the requested action should not
lawfully be accomplished. Pursuant to said authority, I hereby permit City officials to enter upon the property for the purpose of inspection, and if
necessary, for posting a public notice on the property.
Name (please PRINT): Kevin and Barb Bolin
Address: 411 E. Pitkin Street, Fort Collins, CO 80524
Telephone: (970) 310-6171 Signature:
281 N. College Ave, PO Box 580, Fort Collins, CO 80522, (970) 416-2745 F: (970) 224-6134