HomeMy WebLinkAboutDUPLEX - 618 E MYRTLE STREET - BDR240004 - SUBMITTAL DOCUMENTS - ROUND 1 - Supporting DocumentationC ity of
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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 OWN ER NOTIFICATION
PROJE CT NAME : 618 E Myrtle Duplex
CITY OF FORT COLLINS FILE NUMBER: __ 2_3_00_7_8 _
l:il 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 bas 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. I!_!_ r _ _ } • ~
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Applicant's Signature: -fLJ'--'-L....Ll_,,_,,,.......c:..uW---"---~--=-----7_ J_ Date: _L-:-+---1---'-/ _r.p-+ 2 f
State of Colorado )
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County of lb-fl~)
Acknowledged before me this (&,-1" day of __ ~_p.-,---:.r_.( , 20.Jll by
M O'-( 1· (';\. lo•vi(/5ov
Witness my hand and official seal
oaryIC
My commi ssion expires: /. Lf . Lr'
ERIC J LEDOUX
NOTARY PUBLIC
STATE Of C()L0RADO
NOTARY ID 20 114056903
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