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F6rt Collins DEVELOPMENT REVIEW:
APPLICATION FORM
Date Submitted
For Office Use Only
Current Planning File #
Pro ect Inform tio
Project Name, (s.
Project Descri ion ( Moose type of request from he list the ck)i:
esc " ontProjt ddress:
Location cevt,4
Major Cross Streets:
Zone District
Parcel Number°,
Ittilin i/Unit Information
Residential: �ITITITITITITIT Square Feet
Commercial:_IT__ ............ ___Square Feet
Are
Ratio:
Building Industrial:
Floor
Platted Area:"
Number of Units:
Single Family Atta d ..._.. � — irIe FamilyDetache
�
1r"C
Two Family: .. —Multi-Family.--
Total Number of Bedrooms Rented 'Separately:
Dates: AXk 444� J ; �t r t $ ( t$
Conceptual Review Meeting Date
Neighborhood Meeting Date
Hearing Type ..—._..........
Site/Area Information
Residential Area: _.... wSq. Ft. �0 Acres
Commercial Area: Sq. Ft. _ O—Acres
Industrial Area: _ Sq. Ft. ;0%_t —���Acres
Mixed Use Area;. ..ITITIT_ ... t" Sq. Ft.. Acres
Right of Way Area:. _ Sq. Ft, _ Acres
Parking and Drive Area: Sq, Ft., ""° Acres
StormwaLandscater eA Area: Detention Are : SSq*FFt. �ees
Open/Other Areas: q Acs
p
0 a ,Sq. Ft. Acres
Gross Arew-
Floor Area Ratio: -...:• Ft.
— .'.....s ores
Gross Density., .....het Density ....:.. — ...
..°l1 bcrG� • Owner Information Ott fly
Name: + _. M ..._
Address __,._..,
n State: "»
....... Zip:__ _
Ci
City.
e IT Email: .
• �'15t�
Name:
am
Preferred Method of Contact:
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 real property, as those terms are defined in Section 1-2 of the City Code (including
common areas legally connected to or associated with the property wNch is the subject of this application) without whose consent and authority the
requested action could 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 of public notice on the property.
Name (Please RINT
Address; ,.,.
Telephone:
Signature: (and title showing authority to sign, if apofkpe(
Community Development & Neighborhood Services — 281 N College Ave — Fort Collins, CO 80522-0580