HomeMy WebLinkAbout412 E. PITKIN CHANGE OF USE PDP - MINOR AMENDMENT - MA0700044 (21-06) - SUBMITTAL DOCUMENTS - ROUND 1 - APPLICATIONContinents Due By: q' a-o?
Clt}r of Fort Colli11S Zollillb Departlllellt Minor Funen neat # rM D' DOCK `l y
Arm281 N. College Ave. PO Boy; 580 Planner ���^
Fort Collins, CO 80522 Effective Date
City of F�ort� Co t� (970) 416-2745 FA}� (970) 224-6134
Alinor Amendment Application Form
Date Submitted: 2c_07
Project Name:
^ y(a E �'tkt�, 1U19
�/ -7/Ile ,� ! f Minor Amendment Fee: S19? 00
Project Location (Street Address): "//Jc C /e 16
Legal Description: �
rrrg a legal/equitable interest in the properm (Attach separate sheets if necessary)
General Information: List allpr'opertr l+rr.
Owner's Name (s): GL !/
y�a� C e/ f>Ci�? Cite/State/Zip: / vy
Street Address: p�
Telephone: Fax: /]
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Name of firm: / S
Applicant's/Consultant's Name: < Q "U —� �dS3 C
�U City/State/Zip:
Street Address: v!( �� --- Dr7._ y
Telepbone: �17eZ -�� 5 Fax: ���-83�3 Email:k'
SUBMITTAL REQUIREMENTS;
1) Six (6) copses of RECORDED plan (i.e. site, landscape; elevation, etc. -whichever is being altered) on
24" a 36" size (usually available at the Technical Services Department at'_' 81 N. College) — RED -LINE
THE CHANGES ON the six plans or provide s' co s of revised drawings showing thechanges— j"a ne t1 d�piey
tQe•na x• s c• v✓eJ c+: ry.�r�t1 y.
addition to the six originals; a 4) I ; w; t ae �» e Fa Fp,� n1 J� `�°Q roved,,
2) Completed and signed application form; and N /� ve. ��°np" F��u� i ',� ` �` y �Pt Q �tujalrx
3) Application fee ofS192.00. colWeis,ot� < ex%sf, s•'�31e
by can0 1r,'
to nK 't- d- acfCf,t•.ry 'i34 S.F
MINOR AMENDMENTwLu kv� � rea,
Detailed description of the change and reason(s) for the request:
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T�/ CERTIFICATION
n, I am acting with
I certify the information and exhibits submitted are true and correct toncludin t all own rs ha ang a egal oge and that � quitab etinterrest inothe Teal p operty, as
the knowledge, consent, and authority of the owners of the property ( g
defined in Section 1-2 of the City Code; which is the subject of this application) without whose consent and authority the requested action should 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 o� pr�u ��
Name (please PRINT): k - n^ i I'
Address: