HomeMy WebLinkAbout415 N. SHERWOOD ST., ACCESSORY BUILDING W/HABITABLE SPACE - FDP - FDP110010 - SUBMITTAL DOCUMENTS - ROUND 1 - LEGAL DOCUMENTSFlirt Collins
City of
Community Development & Neighborhood services
281 N College Ave. P.O. Box 580
Fort Collins, CO 80526
Phone 970416-2740 Fax 970-224-6134
CERTIFICATION OF MINERAL ESTATE OWNER NOTIFICATION
PROJECT NAME: "//3
CITY OF FORT COLLINS FILE NUMBER: l%
❑ 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.
ndicate by checking the box if the undersigned certifies that the mineral estate
as not been severed from the surface estate for the above named Application
for Development.
S' /
Applicant s Signature Date: -5�o I
State of Colorado )
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County of rl r )
Actc�owledged before me this day of /� ay , 20 / / by
(J� d )— e ram/ o I 1
Witness my hand and official seal
Notary Public
My commission expires:c�mhu•
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