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La Plata County Planning Department/ <br />AGENCY REQUEST FOR COMMENT FORM' -~ <br />(Per Code Section 82-84) <br />This form must be copied and submitted to each agency indicated on reverse side, along with a~the <br />Project's Site Plan or Plat (all pages), Narrative, and Vicinity map. Prepare a package for e~age <br />place in an unsealed, suitably-sized, postage-paid, addressed envelope. These packageust t~ fitted <br />the application to the Planning Department. They will be mailed by the planner to agenctC°sg~er th~p'i~ct <br />application is submitted. ~9p~araa~Ge%er <br />Top Portion to Be Completed by Applicant, Bottom Portion by Agency. <br />PROJECT NAME (as approved b +~pre-app planner): TiloMAtIs~FA/EG a~T EOAn/SYOn/ <br />Oc0 ~Af`rGE 6krx/P, ING ~ c~brr <br />Applicant's Name: ~Yrlr C'o/~CrSMo~Zrm/slnc. Agent's Name: A/~en~t /~,~sr, ~~og~i~ <br />Address: P.D. Sar 2~D~ Address:laep/~fimnf <br />lJdrtanoD. GD ~/,~Q2 <br />Phone: 99D • 2¢)- 2/7Z Phone: <br />Size of Parcel: 3¢.~ otrCS <br />Proposed # of Lots (if subdivision): <br />Proposed use (i.e. residential, commercial, etc.): <br />.Sii~rl ¢6ru/e/ M,:,,i~a ~ f~ressin~ <br />Proposed Water Service: A/onE <br />Project Location: J¢~~G ~p/jv~ir/ 55D <br />Section; Township;3LN Range:_~W <br />Size, number & type of buildings proposed:- <br />/ Exisfii+q 4eL'DSF <br />~iS~nn /4t4~D~~ <br />Proposed Sewer Service: /~i/^/ub/C ~/ie~s' <br />Agency: ~~~ <br />(Applicant must write in each agency and place forms in appropriate envelopes) <br />- --v _ <br />Agency Representative: ) tiowt~ts 1.~.~iT L L, S. ~ Signature: <br />(Please Print) <br />Please return comments within 21 days after receipt of this form to: La Plata County Planning Department <br />1060 East Second Avenue, Durango, CO 81301, (970) 382-6263 <br />Pre-App Planner: <br />Pre-App Date:_ <br />AGENCY COMMENTS <br />