Loading...
HomeMy WebLinkAboutCENTRE AVE. RESIDENCES - FDP - 17-09/A - SUBMITTAL DOCUMENTS - ROUND 1 - APPLICATION[515109] Label sizes of water/sewer services to the proposed buildings. THE WATER AND SEWER SERVICE SIZES ARE NOW LABELED ON THE PLANS AND/OR SPECIFIED IN THE NOTES. Number: 9 Created: 5/5/2009 [5/5/09] At final, label all valves, fittings, connections, etc. FINAL PLANS INCLUDE ADDITIONAL LABELS, AS REQUESTED. Number: l l Created: 5/5/2009 [5/5/09] See red -lined plans for other comments. THE REDLINES COULD NOT BE LOCATED. IF SOMETHING HAS BEEN MISSED OR OTHERWISE LEFT UNADDRESSED, PLEASE CONTACT US. Department: Zoning Issue Contact: Gary Lopez Topic: zoning Number: 1 [4/20/09] No issues. Created: 4/20/2009 Be sure and return all red -lined plans if/when you re -submit prior to a Planning & Zoning Board public hearing on June 18`", or with Final Plan submittal after the hearing. If you have any questions regarding these issues or any other issues related to this project, please feel free to call me at 221-6341. Yours Truly, Steve Olt City Planner cc: Andrew Carney Everitt Companies/Stan Everitt Northern Engineering Current Planning file #17-09 Page 6 Number: 21 Created: 5/6/2009 EAE signs: Please contact me to discuss how to sign the Emergency Access Easement (drive aisles as well as walkways). ADDED SIGNAGE PER MEETING WITH CARIE DANN. SEE SIGN LOCATIONS AND TYPES OF SHEET S2. Number: 22 Created: 5/6/2009 FIRE LINE LOCATED UNDER BUILDINGS: According to NFPA 24 (8-3.1), fire line pipe is NOT allowed to be run under buildings. Your utility plan shows fire lines being run under buildings, between Building 1 and 2, and 1 and 3. Please contact me to discuss. THE FIRE LINE(S) IN QUESTION HAS BEEN REVISED ACCORDINGLY. Department: Stormwater-Water-Wastewater Issue Contact: Wes Lamarque Topic: Stormwater Number: 23 Created: 5/8/2009 [5/8/09] The c-factor calculations are not correct with the amount of impervious area being proposed. Basin B should be around .89 and C100 for this basin around 1.00. Please revise. The c-factor I calculated for the entire site is .63, which is still less than the required .71. THE CALCULATION HAS BEEN REVISED IN THE DRAINAGE REPORT. Number: 24 Created: 5/8/2009 [5/8/09] The water quality volume will need to be recalculated. The impervious area for the site is higher than the calculations show. THE CALCULATION HAS BEEN REVISED IN THE DRAINAGE REPORT. Number: 25 Created: 5/8/2009 [5/8/09] The project can go to a hearing based on the c-factor still less than .71. ACKNOWLEDGED. Number: 26 Created: 5/8/2009 [5/81091 At Final Plan review, the retaining wall needs to have a structural design. Also, the ditch owner needs to be involved and any concerns the company has resolved. PLEASE SEE FINAL PLANS FOR RETAINING WALL DETAIL. THE OWNER HAS BEEN IN CONTACT WITH DITCH COMPANY REPRESENTATIVES. Department: Stormwater-Water-Wastewater Issue Contact: Roger Buffington Topic: Water/Wastewater Number: 6 Created: 5/5/2009 [515109] Fire hydrant coverage has been reviewed with PFA. Remove the proposed hydrant near the east building, and abandon 6-in fire line stub at main in Centre. THE PREVIOUSLY PROPOSED HYDRANT HAS BEEN REMOVED, AND A NOTE TO ABANDON THE EXISTING FIRE STUB HAS BEEN ADDED. Number: 7 Created: 5/5/2009 [5/5/09] A 1-inch water is not adequate for the 10 units included in Bldg 2. A VA WATER SERVICE IS NOW SPECIFIED FOR BUILDING 2. Number: 8 Created: 5/5/2009 Page 5 Number: 5 Created: 5/5/2009 [5/5/09] Please add the following note to the Utility and Grading sheets: Limits of street cut are approximate. Final limits are to be determined in the field by the City Engineering Inspector. All repairs to be in accordance with City street repair standards. THE REQUESTED NOTE HAS BEEN ADDED. Number: 10 Created: 5/5/2009 [5/5/09] The following comments are from Technical Services: 1) Please add a legal description to the Site Plan. ADDED ON SHEET S1 2) There are scanning issues on the Site and Landscape Plans. NOTED AND REVISED Number: 12 Created: 5/5/2009 [5/5/09] Please clearly label what exactly is existing and what is proposed. For instance, are the existing drives changing or moving in any way? PLEASE SEE FINAL PLANS, AND FEEL FREE TO CALL WITH ANY ADDITIONAL QUESTIONS. THE ENTRANCE OFF WORTHINGTON CIR. WILL BE DEMO'D AND RECONSTRUCTED. THE ENTRANCE OFF CENTRE AVE. IS TO REMAIN AS -IS WITHIN PUBLIC RIGHT-OF-WAY. Number: 27 Created: 5/8/2009 [5/8/09] Please identify what exactly is going to be removed/relocated on the site and what will remain. The drive offset on the access onto Worthington Circle, if modified, should not be increased with the new design. If anything, the offset should be eliminated by sliding the new access to align with the existing drive. PLEASE SEE RESPONSE TO NUMBER: 12 ABOVE. THE SLIGHTLY OFFSET DRIVEWAY HAS BEEN APPROVED PER SHERI LANGENBERGER, AND IT IS LISTED AS A VARIANCE ON THE PLANS. Number: 28 Created: 5/8/2009 [5/8/09] See red -lines for additional minor comments. MINOR COMMENTS HAVE BEEN ADDRESSED. PLEASE SEE RETURNED REDLINES FOR ADDITIONAL RESPONSES. Number: 29 Created: 5/8/2009 [5/8/09] It appears that currently the existing walk is a 4-foot wide walk. This does not currently meet our standards however it appears to be in good condition. If any sections of the walk are to be removed it should be replaced in accordance with current standards. ACKNOWLEDGED. Department: PFA Topic: Fire Number: 20 Issue Contact: Carie Dann Created: 5/6/2009 FIRE DEPARTMENT CONNECTION: Please contact me so we can determine optimal location(s) for the FDC(s). A FOLLOW-UP MEETING WITH PFA AND THE FIRE PROTECTION ENGINEER WAS HELD, AND THE RESULTS ARE REFLECTED ON THE CURRENT UTILITY PLAN. IF THERE ARE FURTHER QUESTIONS OR CONCERNS, PLEASE DON'T HESITATE TO CONTACT US. Page 4 [5/13/09] The maximum building height is 61', per the Exterior Elevations Plans. The additional height of the chimneys does not count towards the overall height. Please make this change under BUILDING HEIGHT under LAND -USE STATISTICS. NOTED. DUE TO MINOR ARCHITECTURAL REVISIONS THE MAXIMUM HEIGHT HAS GONE DOWN TO 60-5" AND WAS UPDATED ON THE LAND USE STATISTICS. Number: 35 Created: 5/13/2009 [5/13/09] Per Section 3.2.2(J) of the Land Use Code, the width of the landscaped area between the Centre Avenue ROW and the tier of 7 parking spaces just to the west of the driveway entrance from Centre Avenue must be 10' wide. The width scales to 7'. THE ENTIRE PARKING LOT WAS SHIFTED NORTH CREATING A LANDSCAPE AREA OF 10'-5" Department: Current Planning Issue Contact: Dana Leavitt Topic: Site Plan Number: 13 Created: 5/6/2009 [5/6/09] Per the red -lined Site Plan, show the correct natural Feature Buffer line on the Site, Landscape and Grading Plans and the plat. THE REQUESTED BUFFER LINE IS DEPICTED. Number: 14 Created: 5/6/2009 [5/6/09] Add the following note to the Plat, Site and Landscape Plans: Refer to Section 3.4.1(E) of the Land Use Code for allowable uses within a buffer zone. THE REQUESTED NOTE AND REFERENCE HAS BEEN ADDED. Number: 15 Created: 5/6/2009 [5/6/09] Label buffer line as "Natural Feature Buffer Line" on the Plat, Site, Landscape and Grading Plans. THE BUFFER LINE IS LABELED, AS REQUESTED. Department: Engineering Issue Contact: Andrew Carney Topic: General Number: 2 Created: 5/5/2009 [5/5/09] Engineering Inspection would like to see a more detailed plan of the proposed fire line connection and master fire pump room. THIS ITEM HAS SINCE BEEN FURTHER EXPLAINED AND DISCUSSED. IF A COORDINATION MEETING IS DESIRED TO CONFIRM LIMITS OF WORK AND INSPECTION, WE CAN FACILITATE. Number: 3 Created: 5/5/2009 [5/5/09] Directional pedestrian ramps are required on any reconstructed drives - please contact Transportation Planning for details. PER FOLLOW-UP DISCUSSIONS, THE ONLY RECONSTRUCTED DRIVE IS OFF WORTHINGTON CIR. THEREFORE, THIS ENTRANCE WILL RECEIVE NEW DIRECTIONAL RAMPS, WHEREAS CENTRE AVE. WILL REMAIN AS -IS. Number: 4 Created: 5/5/2009 [5/5/09] Please provide more detail on the existing features surrounding the site such as existing driveways and sidewalks on Centre Avenue and Worthington Circle and what exactly is being proposed to be removed and/or reconstructed. PLEASE SEE FINAL PLANS, AND FEEL FREE TO CALL WITH ANY ADDITIONAL QUESTIONS. Page 3 Department: Current Planning Issue Contact: Steve Olt Topic: Landscape Plan Number: 36 Created: 5/13/2009 [5/13/09] To satisfy the "full tree stocking " requirement set forth in Section 3.2. 1 (D)(1)(c) of the Land Use Code, 3 - 4 more trees (probably ornamental) should be included on the west side of Building One facing Worthington Circle. THERE ARE NOW FOUR ORNAMENTAL TREES ADDED. Number: 37 Created: 5/13/2009 (5/13/09] Per Section 3.2.2(J) of the Land Use Code, the width of the landscaped area between the Centre Avenue ROW and the tier of 7 parking spaces just to the west of the driveway entrance from Centre Avenue must be 10' wide. The width scales to 7'. THE ENTIRE PARKING LOT WAS SHIFTED NORTH CREATING A LANDSCAPE AREA OF 10'-5" Number: 38 Created: 5/13/2009 [5/13/09] With the Final Plan submittal please make sure that Section 3.2.1(D)(3) Minimum Species Diversity of the Land Use Code is met. NOTED, NO SPECIES EXCEEDS 15% OF THE 64 TOTAL TREES. Department: Current Planning Topic: Landscape Plan Issue Contact: Dana Leavitt Number: 16 Created: 5/6/2009 [5/6/09] Extensive native plantings are required within the buffer zone. ADDED. Topic: Photometric (lighting) Plan Number: 17 Created: 5/6/2009 [5/6/09] Fixture CC next to the trash enclosure will have to include a house side shield. Suggest numbering the CC fixtures so that the legend reflects the inclusion of the shield on that fixture only. Fixture type 'CC' is already provided with sharp cutoff optical system that has a house -side shield component built-in internal (optic SR4SC). This is indicated in the description for this fixture type in the lighting fixture schedule. Department: Current Planning Issue Contact: Steve Olt Topic: Site Plan Number: 32 Created: 5/13/2009 [5/13/09] The total number of on -site parking spaces required is 50, not 51 as shown. DUE TO SOME INTERNAL FLOOR PLAN CHANGES THE REQUIRED PARKING HAS GONE TO 18 SPACES PER BUILDING FOR A TOTAL OF 54 REQUIRED. SEE CHART SHEET S2. Number: 33 Created: 5/13/2009 [5/13/09] Based on the subdivision plat there is no street right-of-way (ROW) within the property boundary. Therefore, no ROW should be netted out of the land area, as shown under GROSS AREA COVERAGE under LAND -USE STATISTICS. NOTED AND REVISED. Number: 34 Created: 5/13/2009 Page 2 STAFF PROJECT REVIEW City of Fart Collins VFR Design, Inc. Date: 5/13/2009 c/^RessellLee BRENT COOPER 401 West Mountain Ave. Suite 200 Fort Collins, CO 80521 Staff has reviewed your submittal for CENTRE AVENUE RESIDENCES, PROJECT DEVELOPMENT PLAN - TYPE 2, and we offer the following comments: ISSUES: Department: Current Planning Issue Contact: Steve Olt Topic: Building Elevations Number: 39 Created: 5/13/2009 [5/13/09] Since the 3 buildings have different orientations it would be more appropriate to label the various elevations FRONT, REAR, and END rather than NORTH, SOUTH, EAST, and WEST. ADDRESSED. Topic: General Number: 30 Created: 5/13/2009 [5/13/09] Rick Lee of the Building Department indicated that he is forwarding to the applicant a copy of the 2008 Commercial/Multi-Family Codes & Standards that the City will be enforcing. Also, the applicant is required to schedule a Pre -submittal Code Review Meeting with the Building Department. Please call 416-2341 to schedule this meeting. Number: 31 Created: 5/13/2009 [5/13/09] In general the plans are in very good shape and staff has determined that this development proposal can be placed on the June 18th Planning & Zoning Board public hearing agenda. However, it would be appropriate for the applicant to either submit revisions based on these staff comments and go to a Wednesday morning staff review meeting before June 18th or contact individual staff to ensure that their concerns expressed in this letter can be addressed with Final Plan review and will not preclude the project from going before the Board on June 18th. Department: Current Planning Issue Contact: Dana Leavitt Topic: General Number: 18 Created: 5/6/2009 [5/6/09] A Limit of Development (LOD) line will be added at the time of Final Plan review to the Site, Landscape and Grading plans. DEPICTED ON PLANS. Number: 19 Created: 5/6/2009 [5/6/09] All comments can be addressed at Final Plan review. ACKNOWLEDGED. Page 1 DELICH ASSOCIATES Traffic & Transportation Engineering 2272 Glen Haven Drive Loveland, Colorado 80538 � Phone: (970) 669-2061 Fax: (970) 669-5034 �/ 1 MEMORANDUM To: Stan Everitt, Everitt Companies Luis Hinojosa, VFR Design Brent Cooper, VFR Design City of Fort Collins From: Matt Delich Date: July 14, 2009 Subject: Centre Avenue Residences Transportation Impact Study - . Final compliance (File: 0916ME02) This memorandum provides a final compliance statement that the Centre Avenue Residences site layout, trip generation, and access locations have not changed since the TIS dated April 9, 2009 was completed and accepted by the City of Fort Collins. No further transportation analyses are required. Property Owner Stan Everitt Everitt Companies 3003 E. Harmony Road Suite 400 Fort Collins, CO 80528 P: 970-226-1500 F: 970-223-4156 .v Final Plans Checklist i..l► / 7 v City of Fort Collins Planning and Zoning Submittal ecklist : Final Plan Review The following information is required to be submitted with all applications, unless waived by staff. Any item waived must be dated and initialed by a planner with the City of Fort Collins Planning & Zoning Department. cv Application form an Iling piTransportation Development Review Fee — please contact Engineering at 221-6605 for Information. a� Name and address of each owner of property within the boundaries of the development plan area. List of names of all general and/or limited partners, man germs as d id rectors 2ndior officers an sf- / directors of the corporation involved as either applicants or owners.Ovt��lii`UuS si Q�00 �1 o/' Final Site Plan* (30 copies, 24"x 36" - folded) la'Subdivision Plat* (23copies, 24"x36" -folded) /Y a/14rchitectural Elevations*' (8 copies, 24" x 36" - folded) (p pifandscape Plan* (20 copies, 24"x 36"- folded) / Drainage and Erosion Control Report* (4 copies) p, o" Final Utility and Drainage Plans* (13 copies, 24"x 36"— unfolded) 17 ❑ Requirements for utility plans checklist (1 copy). /,ZO �704Wed' W Transportation Impact Analysis* (TIA), updated* (7 copies), ,--o -Report* (2 copies). f 10 Q—.Deeds.* (contingent on final approval) n 114 --AAylars and PMT* (Mylars not needed until Final plans are approved) 0/14 Other information Director may require: o Subsurface Hydrologic Study* (4 copies) n ❑ Certification of Notice to Mineral Owner(s)* (1 copy) N` ❑ Easements/Agreements* (2 copies, each) ❑ Environmental Reports* *This document is meant to be used as a checklist only. For a more detailed list and explanation of each of these items, please see the handout: "Submittal Requirements: Final Plan Review" Revised December 19, 2007 Final Plans Checklist Accela Automation: ShowPayDetai140 T8108-D Page 1 of 1 RECEIPT CITY OF FORT COLLINS NEIGHBORHOOD & BUILDING SERVICES 281 N. COLLEGE AVE. Phone:970-221-6760 P. O. BOX 580 Fax:970-224-6134 Application # : B0904019 Project Name (Subdivision) : CENTRE AVENUE RESIDENCES Application Type : Building / Misc / General / NA Receipt No.: 142925 Payment Method Ref Number Amount Paid Payment Date Cashier ID Comments Check 041598 $2,000.00 07/15/2009 10:16:58 AM SLINDELL FINAL PLAN FEES FOR CENTRE AVE RESIDE Owner Info.: Work FINAL PLAN SUBMITTAL PLANNING FEE - $1,000 FINAL Description: TRANSPRORTATION DEVELOPMENT FEE - $1,000 PAID BY EVERITT ENTERPRISES INC CK#041598 T8108-D Version 4.0 https://dtsweb02.fcgov.comloperationslpennitlindex.cfm?FUSEACTION=ShowPayDetail40&RECEIPT_... 7/ 15/2009 a Citvof Fort Conies Transportation Development Review Fee Date Received/ Paid o� ��/J Project Name: �Ayd •e_ A%letnuP kkl;Ske4vtCps Total Amount Paid Project Location: Date: Type of Submittal Please indicate the type of application submitted by checking the box preceding the appropriate request(s). 7 Overall Development Plan (ODP) Final Development Plan (FDP) This fee includes 2 rounds of review 7 Additional round of review 7 Annexation $20 x 7 Minor Amendment -1 Major Amendment -1 Re -zone -1 Modification to Land Use Code Fee structure amount due S500 each S1000 each S 500 each acres = + $250 = $250 each $2,500 each S200 each S200 each Wireless Telecommunication Equipment (WTE) $65 each :1 Road Projects acres (of roadway) X $250 = -1 Vacation of Easement(s) *"* # of vacations _ X S400 = .3 Vacation of Right(s)-of-Way *** # of vacations X $800 = 7 Dedication of Easement(s) and/or Right(s)-of-Way *** # of dedications X $250 = *** This fee does not include the cost of filing fees. Filing fees shall be determined at the time of final document submittal and will be required prior to filing. Project Development Plan (PDP) or Basic Development Review Project requiring Transportation Services Review and/or utility plan review. This fee includes 3 rounds of review. Detached Single Family $ I60 per unit # of units X S 160 = Multifamily or other residential units $115 per unit _#of units XS115= Commercial, Industrial, Retail, and/or Non residential building square footage $0.25 per square foot sq ft X $0.25 = Size of the development (area being platted or if not being platted size of parcel accompanying all development improvements) S250 per acre acres X $ 250 = Project fee S2,000 each S2 000 Total of above amounts If this fee amount exceeds $30,000 then the fee amount shall be adjusted with the following formula: $30,000 + %¢ (the amount over 30,000 The maximum fee for any residential ONLY project shall be $500 per residential unit. This check should be used to verify the fee amount (does not apply to mixed -use developments). PDP fee shall be the lesser of this amount or the above calculated amount. # of residential units X $500 = Reduction for affordable housing - a copy of the City letter certifying/ authorizing the affordable housing shall be provided with this application. Amount of reduction to be applied Total owed for PDP $ / BC-yo Land Use Information: Total number of single family detached units: Total number of multifamily/other residential units: ' (� Total number of certified affordable dwelling units (a copy of the letter/ authorization is required): Non residential building square footage: sq ft Gross Acreage: :cif acres General Information: 1% Owners Name(s): 5fAm &Xir f p 1J Fa NIPS Street address: f?G'903 tr vt,«uu f Sd, 4 1010 City/State/Zip: &I ) 0?05]L%- Telephone: ZU - (SUo Fax: ,_S ^ w 7y Applicants/ Consultants Firm Name: Vf_�2 OQSi'q K _41 C, Contact: (00l02r Street address: M OV K lest el Wye, City/State/ Zip: f }jy- 6 (11 `in S � co Telephone: 2,24-1 1 t Fax: `2Z ^t662 Certification: By signing this permit I acknowledge that I am acting with the knowledge, consent, and authority of the owners of the property (including all owners having legal or equitable interest in the real property, as defined in Section 1-2 of the City Code; and including common areas legally connected to or associated with the property which is the subject of this application) 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 purposes of inspection. �q] Name (please jint): (mob Signature: Telepho D. cc: Christie White, Engineering Development Review Engineering L F�41 /3�-09/,4 Type of Request Please indicate the type of application submitted by checking the box preceding the appropriate request(s). Additional handouts are available explaining the submittal requirements for each of the following review processes. ❑ Annexation Petition with Initial Zoning REQUESTED ZONE: _ Fee $1,188.00 + $50.00 sign posting fee + S.75 for each APO label ❑ Rezoning Petition REQUESTED ZONE: Fee $977.00 + $50.00 sign posting fee + $.75 for each APO label ❑ Overall Development Plan (ODP) Fee: $1,599.00 + $50.00 sign posting fee + $.75 for each APO label ❑ Project Development Plan (PDP) without Subdivision Plat Fee: $3, 887.00 + $50.00 sign posting fee + $.75 for each APO label ❑ Project Development Plan (PDP) with Subdivision Plat Fee: $5, 879.00 + $50.00 sign posting fee + $.75 for each APO label ❑ Final Plan without Subdivision Plat Fee: $1,000.00 Final Plan with Subdivision Plat Fee: $1,000.00 ❑ Modification of Standards/Text and Map Amendment Fee: $200.00+ $50.00 sign posting fee Cl Basic Development Review Fee: Varies: Check with the Zoning Department ❑ Major Amendment Fee: $3, 206.00 + $50.00 sign posting fee + $.75 for each APO label ❑ Non -Conforming Use Review Fee: $1,389.00 ❑ Vacation of ROW or Easement Fee: $5.00 per sheet of filing document ❑ Small Project Fees Fee: Varies -Check with the Current Planning Department ❑ Street Name Change Fee: $5.00 ❑ Extension of Final Approval Fee: $566.00 ❑ Site Plan Advisory Review NO FEE Fort Collins Current Planning Development Review Application For Office Use Only Date Submitted /S 0 Current Planning File #_tR!Q� Planner STD 01�4 Project Name: CEVrM Atl -4JUP, ftsi f imeez. Project Location (Street Address): C CV9fJSJ- 417' CZ&(12E AVJ9 �f I kX GiYl�l Land Use Information: Gross Acreage/Square Footage: Existing Zoning: E. Proposed Use: M11L71—FA tli Total Number of Dwelling Units: 3 O Total Number of Affordable Dwelling Units: Percentage of Affordable Dwelling Units (out of total): Total Commercial Floor Area: Additional Information (if Applicable): Project Description: 2jo umij'AUsrJ--AW1LL1 (Choose the type of project from the list on the back) General Information: List all property owners having a IegaUequitable interest in the property (attach separate sheets if necessary). Owner's Name(s): eWJ?/ 1T C•Mf*M1Ar. NWII M Street Address: 300 a E. khk*A4h?f OP. CIWW_ J QM City/state2ip: -50r ebtUAJS Bi*26 Telephone: Z2&- /500 Fax: ZZ3-4158 Applicant's/Consultant's Name: YFj_ PM6r J / IJG. Nameoffinn: Wile— P9b6-IJ /tJG• Contact MeoT GooPr>— Street Address IP/ M. hOL;A N AJ AWE , Sv1M_2CD CitylState/Zip: f T &WfflS, La 6OS21 Telephone: R%C} 2Z¢_//9 Fax: J-" 22¢ Il by E-mail: K�rJTC'DK�V�2SIVhI /NG.Cp/n CERTIFICATION I cerlify 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 real property, as those terms are defined in Section 1-2 of the City Code (including common areas legally connected to or associated with the property which is the subject of this application) 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 of public notice on the property. Name (Please PRINT): 13Pepcf- laowW Address: 9111 0, ,tt• <,);ie2-#7 Fer •I ina. GO 8'052/ Telephone: 170 • 14'Z Iq 1 Sig a re: X(aitle showing authority to sign, if applicable) CERTIFICATION MUST BE SIGNED. a