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Home My WebLink AboutSAMS CLUB FUEL STATION - MJA200002 - - VARIANCE REQUESTStormwater Alternative Compliance/Variance Application City of Fort Collins Water Utilities Engineering Section A: Engineer/Owner Information Engineer Name____________________________________________Phone___________________________ Street Address_____________________________________________________________________________ City__________________________________________State________________________Zip_____________ Owner Name______________________________________________Phone___________________________ Street Address_____________________________________________________________________________ City__________________________________________State________________________Zip_____________ Section C: Alternative Compliance/Variance Information Section B: Proposed Project Information Legal description and/or address of property____________________________________________________ Project Name______________________________________________________________________________ Project/Application Number from Development Review (i.e. FDP123456)__________________________ Description of Project_______________________________________________________________________ __________________________________________________________________________________________ Existing Use (check one): ☐ residential ☐ non-residential ☐ mixed-use ☐ vacant ground Proposed Use (check one): ☐ residential ☐ non-residential ☐ mixed-use ☐ other____________________ If non-residential or mixed use, describe in detail_______________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ State the requirement from which alternative compliance/variance is sought. (Please include applicable Drainage Criteria Manual volume, chapter and section.) What hardship prevents this site from meeting the requirement? What alternative is proposed for the site? Attach separate sheet if necessary Attach separate sheet if necessary page 2 The owner agrees to comply with the provisions of the zoning ordinance, building code and all other applicable sections of the City Code, Land Use Code, City Plan and all other laws and ordinances affecting the construction and occupancy of the proposed building that are not directly approved by this variance. The owner understands that if this variance is approved, the structure and its occupants may be more susceptible to fl ood or runoff damage as well as other adverse drainage issues. Signature of owner:_____________________________________________Date:_______________________ The engineer hereby certifi es that the above information, along with the reference plans and project descriptions is correct. Signature of engineer:___________________________________________Date:_______________________ PE STAMP If you have questions or need assistance fi lling out forms, contact Fort Collins Utilities at: Phone: 970-221-6700 · TDD 970-224-6003 Web: fcgov.com/stormwater · Email: WaterUtilitiesEng@fcgov.com UtilitiesOffice use onlyDate complete application submitted:_____________ Date of approval/denial:__________________________ Variance: ☐ approved ☐ denied Staff justifi cation/notes/conditions:_______________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Approved by:__________________________________ Entered in UtilityFile Database? ☐ yes ☐ no