HomeMy WebLinkAboutPOUDRE VALLEY HOSPITAL 1024 SOUTH LEMAY PARKING LOT LIGHTS - Filed MA-MINOR AMENDMENT - 2003-01-14Page is too large to OCR.
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dhCity of Fort Collins Zoning Department Comments Due By: T_03 c
281 N. College Ave, PO Box 580 Minor Amendment # 14 A U a O Op rj
Fort Collins, CO 80522 Planner 4, ,
City ofCitr F� (970) 416-2745 FAX (970) 224-6134 Effective Date // ^
Minor Amendment Application Form
Date Submitted: cJal4 tJV 2
Project Name: (IAYLW, VA
Project Location (Street Address):.
Legal Description:
Minor Amendment Fee: $192.00
General Information: List al! property ow ters having a le al/equitable interest in the�Property (Attach separate sheets if necessary).
Owner's Name (s): S Q
Street Address: 2315 �.-iaL✓t a City/State/Zip :✓r trt.s �� /�Z)S2J
Telephone: Zw % - -]D 1 3 Fa . 237 . 70`�0
Applicant's/Consultant's Name: �ti MI �LWSK Name of firm:
Street Address: 1 6Pb 3 ity/State/Zip: _��.
Telephone: =2) • "7 = 7 Pax: ZZ3 jb 2—% Email:
SUBMITTAL REQUIREMENTS:
1) Six (6) copies of RECORDED plan (i.e. site, landscape, elevation, etc. - whichever is being altered) on
24" x 36" size (usually available at the Technical Services Department at 281 N. College) — RED -LINE
THE CHANGES ON the six plans or provide six copies of revised drawings showing the changes in
addition to the six originals;
2) Completed and signed application form; and
3) Application fee of $192.00.
MINOR AMENDMENT
Detailed description of the change and reason(s) for the request:
CERTIFICATION
I certify the information and exhibits submitted are true and correct to the best of my knowledge and that in filing this application, I am acting with
the knowledge, consent, and authority of the owners of the property (including all owners having a legal or equitable interest in the real property, as
defined in Section 1-2 of the City Code; which is the subject of this application) without whose consent and authority the requested action should not
lawfully be accomplished. Pursuant to said authority, 1 hereby permit City officials to enter upon the property for the purpose of inspection, and if
necessary, for posting a public notice on the property.
Name (please PRIM);
MW