HomeMy WebLinkAbout1415 W Elizabeth St - Minor Amendment/ Application - 10/01/1991PLANNINtID ARTMENT
APPLIC TION FORM
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City of Fort Collins
�e7—r / Land Use Information:
Project Name: Gross Acreage/Square Foota e
Project Location (Street Address): /S 'v <=�'��f/3�%'h/ g : -
Project Description: _/J47 %Ti'o 7 7—d -Y
Existing Zoning:
Proposed Use:
_ Total Number of Dwelling Units:
Today spate: / / �� Total Commercial Floor Area:
GENERAL INFORMATION: Applicant's Name: tTUr /x0/^a'3 orrConsultant's To�9 Go7�i- Gi-i`�rg
Name:
Owner's Name: 1a�Y1 �o%�l� O ororJ�i�d i¢/i
� Street Address: ��T �, Street Address:
Street Address: ! ' 9 . /30 i1 q %! D o City, State, Zip: t9r D 0 City, State, Zip:
City, State, Zip: �71 G o w11¢ 6 #517' y,�1,, 9 _ Telephone: -A IE4' Iq 1X —..OYAsS Telephone:
TYPE OF REQUEST
Please indicate the type of application submitted by checking the box preceding appropriate request(s). Combined requests require the combined individual fees.
Make checks payable to the City of Fort Collins. Starred requests (•) also require additional payment to Larimer County Clerk and Recorder in the amount noted.
Additional handouts are available explaining information requirements for each of the following review processes.
Please sign certification on reverse side 5r91
PUD ADMINISTRATIVE CHANGE
Description of the change and reason(s) for the request:
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Planning
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Building Inspecti
Action: /114XP�
Date: 3-
By:
Engineering
Action:
Date:
By:
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CERTIFICATION
I certify the information and exhibits herewith submitted are true and correct to the best of my knowledge and that in filing the
application I am acting with the knowledge, consent, and authority of the owners of the property without whose consent and authority
the requested action could 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.
// . / _ n
Name:
Address:
Telephone: