HomeMy WebLinkAboutNEW PROSPECT - FDP - FDP120011 - SUBMITTAL DOCUMENTS - ROUND 1 - LEGAL DOCUMENTSCity of Community Development & Neighborhood Services
Flirt Collins 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: �Ew
CITY OF FORT COLLINS FILE NUMBER: F h 0-0 I
❑ 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:
State of Colorado )
) ss.
County of LW au )
Date: -7 ry It, Z
Acknowledged before me this Vday of , 20—)c�_ by
Witness my hand and official seal
RONMEXPRESM4WO
otary Public N
01L1 STAT
My commission expires: 0 � —oZ
MY COMMISSION