HomeMy WebLinkAboutWINC-WATSON - BDR240015 - LEGAL DOCS - Legal Documents City of Community Development&Neighborhood Services
Fort Collins 281 N College Ave. P.O.Box 580
Fort Collins,CO 80526
Phone'970416-2740 Fax 970-224-6134
CERTIFICATION OF MINERAL ESTATE OWNER NOTIFICATION
PROTECT NAME: 41j1, — Vy 0 S AkAulow
CITY OF FORT COLLINS FILE NUMBER:
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 Devised
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 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.
❑ Indicate by checking the box if the undersigned certifies that the mineral estate
has not been severed from the surf ce esta f the above named Application
for Development.
Applicant's Signature: Date:
State of Colorado
) Ss,
County of ft t - )
Acknowledged before me this 401 day of no avatf 202z4 by
Witness my hand and official seal
FEmily Ellingson
OTARY PUBLIC
Notary Pub ' E OOLORADO
1 Y ID#20IM190
My commission expires: Y SIOW EMPIRES 6512312�