HomeMy WebLinkAboutPOLESTAR VILLAGE - FDP240010 - LEGAL DOCS - Legal DocumentsCity of
ktColli~
Co mmunity Development & N eighborhood Serv ices
281 N College A ve. P.O . Box 580
Fon Collins , CO 80526
Phone 970-4 I 6-2740 Fax 970-224-6134
CERTIFICATION OF MINERAL ESTATE OWNER NOTIFICATION
PROJECT NAME: &w_,e, W'LM,4Jf:
CITY OF FORT COLLINS FILE NUM_BER: //)/J ;:J..,:}./)()10
□ The undersigned does hereby certify that the developer/applicant for the above
named Application for Development in the City of Port 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.
D 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. I 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.
Applicant's Signature: ~ Date: 512P-~
State of Colorado )
) ss.
County of }._,. r'· "'"i/ )
Acknowledged before me this 22 day of _~H_~M"""-+-------• 20 2-.4:. by M. ;tJ,..,..t). born: I~ J
Witness my hand and official seal -,t;;, µ -
N~blic
My commi ssion expires : ~i.lAf~ Z.e:; 1 µ,z."(
AARON DYLAN MAPLES
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20234003296
MY COMMISSION EXPIRES JANUARY 25, 2027