HomeMy WebLinkAboutDINGS - BDR240016 - LEGAL DOCS - Legal Documents City of Community Development&Neighborhood Services
Fort Collins 281 N College Ave. P.O.Box 580
Fort Collins,CO 90526
Phone 970-416-2740 Fax 970-224-6134
CERTIFICATION OF MINERAL ESTATE OWNER NOTIFICATION
PROJECT NAME\C� C�- ,
CITY OF FORT COLLINS FILE NUMBER:
M 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 surface est to f r the above named Application
for Development.
r
Applicant's Signature: Date.
State of Colorado
) ss.
County of )
Acknowle I TAN1aASCTV-\
efore me thisday of i l[ fA� J , 20by
. a
Witness my hand and official seal
Emily Ellingson
pv ,,,, NOTARY PUBLIC
OUV STATE OF COL.ORADO
C NOTARY 1D#20164019483
MY COMMISSION E)P1RES 051231M
My commission expires: Mall Mwb