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"`"""'"'''"'" Larimer County Planning <br />_ Application Form <br /> Type of Application <br /> (Check All That Apply) <br />^ Minor Residential Devebpment ^ Land Use Plan Amendments ^ Recording Plat -Subdivision <br />^ Minor Land Division ^ Resolufan amendments ^ BOA -Zoning Variance <br />^ Amended Exemption ^ Amended Plat -Subdivision ^ BOA -Special Exceptbn <br />^ Boundary Line Adjustment ^ Sketch Plan /Concept Review ^ BOA -Appeal of Staff Decisbn <br />^ Add - On Agreement ^ PUD Master Plan ^ Rezoning <br />^ Vacation of ROW /Easement ^ Preliminary Plat -Subdivision K8 Special Review <br />^ Street Name Change ^ Final Plal -Subdivision ^ LoCat'an and Extent <br />THIS APPLICATION IS FOR: <br />,ta CTR O PLANNING COMM. ^ UGA REVIEW BRD ^ BOARD OF ADJUSTMENT ^ BOARD OF COMMISSIONERS <br />Previous File Number: (STAFF WILL FILL IN) Choice <br /> <br /> General Information <br />Property Owner: I r• <br />Name: Akexanden B, Lo.tte J., E Sa nd~w h!. Ghana Agency: Tuttle Apple ate, Inc. <br />Address: 4308 East County Road X36 Contact Per on: j~~on n <br />City/State2ip: Fo o n6, Address: 199 ran e e <br />Phone: (H) (W) CitylState2ip 1)enveh. CU 80233 <br />Property Owner: Phone: (30~ 452-6611 <br />Name: rv r• <br />Address: Agency: <br />City/State2ip: Contact Person: <br />Phone: (H) (W) Address: <br />Property Owner: City/State2ip <br />Name: Phone: ( ) <br />Address: ~ I n r• <br />City/State2ip: )t~. Planning Consultant: <br />Phone: (H) (W) Agency: n,r1Po Ar Po9nto, inr_ <br />II n : Contact Person: John Jordan <br />Name: Conne,2.P Reaouhceh Address: 11990 Grant S.Ureet, Suite 410 <br />Address: 4305 Eaht Hahmony Road City/State/Zip Denveh., @0' 80233 <br />CifylStatelZip: Font CoCZi.rvs, CU 80525 Phone: ( - <br />Phone:(H) (W) - <br /> Signatures <br />I hereby certify that I am the lawful owner of the parcel(s) of land which this application concerns and consent to this action. I hereby pennft county <br />offidals to enter upon the propery for the purposes of inspection relating to this app ion. Please Note: BuBdnp Ferrite eamot be Issued <br />while this a Callon Is~er~t ~ <br />l <br />~ <br />~ <br />~ <br />Owner: //~ <br />n / <br />~ L~~ l i r U 1~''-n. ~ ~+ 0 /-' <br />:.,.~tifr 7: <br />' <br />~1 /1 _.. <br />. <br />~ <br />Ihereb fe tAyth theiffi nforma4on exh~he ~ <br />~ <br />submittedaretrueandoorreatothebestofmykrawledgeandttra2infilingtheapplicafion <br />I am acting with the knowledge and coruent of the owners of the properly. I understand and agree that tNs proposal may be delayed In <br />ptoeessing N the Intwld~d,ls lrtcomplete, InacuraEe, a submitted aRer fhe submittal deadllre. <br />/ <br />/ <br />/ <br />Appllcard: e,r r-•-la <br /> <br />PLEASE NOTE SUBMTTAL DEADLMFS: Applkatbns submitted after 1290 p.m. on submittal deadline days will nd bs ecaspted. <br />Please cornpleta ssctbns on the reverse side. <br />File # RID Check # Amourn Paid S Sign Given <br />LCPZ 1051092 <br />