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GENERAL CARE HEALTH SERVICES - FDP - 22-00 - SUBMITTAL DOCUMENTS - ROUND 1 - APPLICATION
MINOR AMENDMENT Description o0tte change anreasons (s) for the request: APPROVALS: Planning Action: Date: Building Inspection Action: Date: Engineering Action: Date: Other (if applicable): CERTIFICATION I certify the information and exhibits submitted are true and correct to the best of my knowledge and that in filing this application, I am acting with the knowledge, consent, and authority of the owners of the property (including all owners having a legal or equitable interest in the real property, as defined in Section 102 of the City Code; and including common areas legally connected to or associated with the property which is (he subject of (his 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 (he property for the purpose of inspection, and if necessary, for posting a public notice on the pro pert Name (please PRINT): r j�(,TjjQ�[ ()NE . P.C, / 1-kAA7J .C/i1 G, 11 vTr i ,err,: Telephone: �� �/ P iFi�n� /„/,.n Signature: Today's Date FEET( A&T ' ; 0001 I I For Office Use Only; Effective Date �I Current Planning file h�2�� Planner�,� �j Project Narne:�j�& ,r AEE INE -114 SERV IG r (1�. Project Localion (Street Address): (,EAdA 4, 9 f0U0 , r\Na. Project Description: `F MM6� NCO( 41p, awl a" I.I& D+l.g-f,- 0im @ -e tm-NFAew, /,,qrwF-.P— ,7F bEMA� M6NO�, AAA MUW, RIVI;�. MNE�. General Information: List all property owners having a legal/equitable interest in the property (Attach separate sheets if necessary). Owner's Name (s): (HA F:Le fG� GJ (IATC,t IETT� Street Address: M �AOF EL{ZO(ft-1-H 6gga City/State/Zip: _fpET 6oww;g/ , Gp Telephone: 434-0AoQ /492-(6(OZOFax: ZZI�_9j�(p Current Planning Department Application Form ckGo ZZ0I Land Use Information: Gross Acreage/Square Footage: ?j (i 50I 5 F. Existing Zoning:_ 6 Propose Use: UVICAI.., 6441 Total Number of Dwelling Units: f�[A Total Commercial Floor Area: $, tOZIp GJ Applicant's/Consultant's Name: / j }Q��L;�G� 61, (( E Contael:-ALk� RA02H,, AIZCNfi " Street Address: ' - 51UME Cily/Stale/Zip: 1 VE.GAt p , eo ?7 Telephone: 4.--90&0 Fax: =9©(OHO Type oi' Request Please indicate the type of application submitted by checking the bar preceding appropriate request(s). Additional handouts are available explaining submittal requirements for eactr of the following reviely processes. ❑ Annexation Petition with Initial Zoning REQULSTED ZONE: Fee 31,188.00 ❑ Rezoning Pelilion REQUESTED ZONE: Pee %977.00 J Overall Development Plan (ODP) Fee: $1,599.00 1 $.50 for each AI'O label O Project Development Plan (PDP) without Subdivision flat Fee: $3,887.00 + $,50 for each APO label O Project Development Plan (PDP) with Subdivision I'lat Pee: $5,879.00 + $.50 for each APO label ❑ final Plan without Subdivision Plat Fee: $1,000.00 Final flan with Subdivision Plat Fee: $1,000.00 Ll Preliminary Subdivision Plat Fee: $1,3120.00 U Final Subdivision flat I�cc 12-176-Ott ❑ Minor Amendment Fee: $192.00 . U Major Amenrlmeut Pee: $3,206.00 ❑ Non -Conforming Use Review Fee: $1,389.00 ❑ Vacation of ROW or Easement Pee: $5.00 per slice[ of filing document ❑ Small Project Fees Fcc: Varies -Check with the Current Planning Department ❑ Street Name Change Fec: $5.00 ❑ Extension of Final Approval Fee: $566.00 ❑ Modi6caliou of Standards Fce: $200.00 0CERTIFICA7 ON 0NREVF.RSE SIDE A I US 7 B E SIGNE1). c 7 City of Fort Collin. �t�