HomeMy WebLinkAboutBANNER HEALTH MEDICAL CAMPUS - Filed MA-MINOR AMENDMENT - 2019-05-29Fi�,�`o"rYtCollins
Date Submitted:
Comments Due By:
Minor Amendment # _
Zoning Facilitator:
MA180063 —
Effective Date:_ 9/ 19/2018
THIS BOX IS FOR OFFICE USE ONLY
Minor Amendment Application Form - Zoning Department
The requested information on this application is required.
Project name: FCMC Temporary Modular Cath Lab
Project Location (Street Address): 4700 Lady Moon Drive
General Information: List all property owners having a legal/equitable interest in the property (Attach separate sheets if necessary).
wner's :Names . 8annm H-*
Street Address: 4700 Lady Moon Drive City/State/Zap: Fort Colllns/CO/80528
Telephone: (970) 810-3951 Email: Jim.Horiike@BannerHealth.com
[Applicant Nam : Terrell Hastings
Name of firm: Tobin & Associates, P.C.
Street Address: 1820 Dillon Ave, Suite 200A _ City/State/Zap: Cheyenne/WY/82001
Telephone: (307) 632-3144 _ Email: Terrell@Tobin-assoc.com
SUBMITTAL REOUIREMENTS:
1) The initial submittal and additional rounds of review shall be electronic (one (1) copy on a CD or Flash drive) of
the site, landscape, elevation, etc. - whichever sheets are being altered. A Legal Description is required. Changes
on each sheet should be clouded.
Once all departments approve the proposed changes a Final Hard Copy will be required to be printed on 24"06"
Mylar sheets. Please ensure the electronic submittal can be printed to scale on 24"06" sheets.
2) Complete and sign Minor Amendment application form and Transportation Development Review Fee application
form (TDRF). The following link is to the TDRF application form:
https '/www fcgov com'engineering'pdf-TDRF2012ap lip cationformpdP1365616099
3) Application fee of $350.
Note: an additional $250 fee is required if the Poudre Fire Authority (PFA) needs to review the application.
Typically, PFA fee is required for all changes of use, building additions and/or new buildings.
MINOR AMENDMENT
Detailed description 4the change and reason(s) for the request:
FCMC needs a catherization lab for out -patients. A temporary modular cath lab will be used for up to two
years while a permanent lab is being designed and constructed. The location of the modular lab is situated
in between two of the existing wings of the hospital and set back to minimize view from the public street
which is adjacent to the existing MRI Trailer parking pad. The original drawings indicate the space between
the wings will eventually be built -out with hospital space and it is still on the schedule for design.
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, I 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 PRINT): Terrell Hastings
Address: 1820 Dilion Ave., Suite 200A, Cheyenne, WY 82001
Telephone: (307) 632.3144 Signature:
281 N. College Ave, PO Box 580, Fort Collins, CO 80522, (970) 416-2745 F: (970) 224-6134
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