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HomeMy WebLinkAboutMAINSTREET HEALTH & WELLNESS SUITES - FDP - FDP150006 - SUBMITTAL DOCUMENTS - ROUND 1 - LEGAL DOCUMENTSFort 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: Mainstreet Health & Wellness Suites CITY OF FORT COLLINS FILE NUMBER: PDP140018 ❑ 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. MS 50q Colltr)s L1C By=MeanStrcc� 55e�F Managac�en+, 1nc� Its Cf Applicant's Signature: ��rw1/� Date: ah 015 f State ofFe ) r ) ss. fl County of I I) Acknowledged before me this � day of )Witness my hands foT. 'fit 1W�'U�� 1-L'� i expires: ��`�aalb+ollr��os` ;G �a r'°�`3' ?� NOTARY SEAL ;�, 20 by ofiatcp