HomeMy WebLinkAboutRICHARD'S LAKE P.U.D., FILING ONE, SECOND REPLAT - PDP/FDP - FDP120004 - SUBMITTAL DOCUMENTS - ROUND 1 - LEGAL DOCUMENTSCity of
F6rt Collins
Community Development & Neighborhood Services
281 N College Ave. P.O. Box 580
Fort Collins, CO 80526
Phone 970-416-2740 Fax 970-224-6134
CERTIFICATION OF MINERAL ESTATE OWNER NOTIFICATION
PROJECT NAME:1FtC 1tAZD S LgIGE PtAn FtC.t►JG ( S ECo1JD 7,F—f"T
237—
CITY OF FORT COLLINS FILE NUMBER:
The undersigned does hereby certify that the developer/applicant for the above
named Application for Development in the City of Fort Collins has provided
notice as required pursuant to Section 24-65.5-103 of the Colorado Revised
Statutes to any owner or lessee of a mineral estate underneath a surface estate
that is subject to the Application for Development, or that the developer/applicant
has obtained a waiver of the right to notice from any such mineral estate owner.
❑ If a waiver has been obtained, a copy thereof must be attached to this certificate.
Indicate by checking the box if attaching a copy of the waiver signed by all
mineral estate owners.
❑ Indicate by checking the box if the undersigned certifies that the mineral estate
has not been severed from the surface estate for the above named Application
for Development.
Applicant's Signature: Date:
State of Colorado )
) ss.
County of DattvgP, )
Acknowledged before me this 15 day of JIAX-_ 2012 by
Witness my hand and official seal
CHRISTOPHER A RIVERA
Notary Pub is Notary Public
State of Colorado
My commission expires: 3,7-*2-(t�.