HomeMy WebLinkAboutANDERSON DENTAL CLINIC - RH NON-RESIDENTIAL USE REQUEST - 25-87 - - APPLICATION-- COMMUNITY DEVELOPMENT DEPARTMENT
PLANNING DIVISION APPLICATION FORM CITY OF FORT COLLINS
Project Name: AWDOZ60A L.
Project Number:
Project Location
Today's Date:
•
or Street Address_ r.�Z'� �• REM h3
GENERAL INFORMATION:
Owners Name: M AJkLo 500A,VOLS -
Address
Telephone
Land Use Information:
Gross Acreage/Sq. Footage:
Existing Zoning: R
Proposed Use: �1b1.��r OGvt
Total Number of Dwelling Units:
Total Commercial Floor Area: 1� S
Applicants Name: Contact Person:
Address: 57Z « - Address:
Telephone: '?16—t - 19+61 Telephone: S "e
TYPE OF REQUEST:
Please indicate type of application submitted by checking the box preceding appropriate request(s). Combined requests, except for Final
PUD and Final Subdivision, require the combined individual fees. No application will be processed until all required information is provided.
Additional handouts are available explaining information requirements for each of the following review processes.
5/1985
`Please make check payable to Larimer County Clerk and Recorder. (OVER)
PUD ADMINISTRATIVE CHANGE
Description of the change and reason(s) for the request:
Planning Division:
Action:
Date:
By:
Building Inspection:
Action:
Date:
By:
Engineering:
Action:
Date:
By:
CERTIFICATION
I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that
in filing the application I am acting with the knowledge and consent of the owners of the property without whose consent the requested
action c�
Name:
Address
Telephone: "C"0 ���