HomeMy WebLinkAbout315 WEST OAK STREET A T & T ROCKY MOUNTAIN BANK - Filed T-TELECOMMUNICATION PLANS - 2015-01-22 (2)City of 6hh
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Minor Amendment Application Form
Date Submitted:
Project Name: WA&gk-5 ..�j %� a� --g aid <15
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Project Location (Street Address): 13) �45 w , Q f,, ICE 5j- y QR
Legal Description: ('1J (U1J .
Comments Due By:_(9' S -16
Minor Ame ment # MA 1,100949
Planner. NN j. j
Effective Date -7'
- Zoning Department
General Information: List all property owners having a le al equitable interest in the property (Attach separate sheets if necessary).
wner's Names : CM_ S&rt e UPSI r12r's 01ixys t If
Street Address: 4-1 Q�. , SILK �" City/State/Zip: r--oY r! ( , d lI i�n$ cQ So `- Z
Telephone: - • 45Z G968 Fax:
A licant's/Consultant's Nam j U� o o►'1 Q v,� Name of firm:
Street Address: `f (o `J. 1 City/State/Zip: I' l i C C 0 'ibl 1
Telephone: 303 � 4 • 3-455 Fax: Z Qp • 36� Email: 1 pp
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SUBMITTAL REQUIREMENTS:
1) Eight (8) 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 eight plans or provide eight copies of revised drawings showing the changes in addition to the
eight originals. ALL PLANS MUST BE FOLDED TO 8 1/2" X 11";
2) Completed and signed Minor Amendment application form and Transportation Development Review Fee
application form.
3) Application fee of $350 ($192.00 Minor Amendment Fee plus $158 Transportation Development Review Fee).
Note: an additional $250 fee is required if the Poudre Fire Authority needs to review the application.
MINOR AMENDMENT
Detailed description of the change and reason(s) for the request:
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 onthethe prope
I rity.
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Name (please PRINT):
Address:
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Telephone: LI - �) Signature:
281 N. College Ave, PO Box 580, Fort Collins, CO 80522, (970) 416-2745 F: (970) 224-6134