GENERAL55854

• Permit No: M1985115
• IBM Index Class Name: General Documents
• Doc Date: 4/12/1999
• Doc Name: AGENCY REQUEST FOR COMMENT FORM
• Media Type: D
• Archive: No

iPlata County Planning Department. III III~IIiIIIIII'll
AGENCY REQUEST FOR COMMENT FORM
This farm must be copied and submitted to each agency indicated on reverse side, along with a copy of the
Project's Site Plan or Plat (all pages), Narrative, and Vicinity map. Prepare a package for each agency and
place in an unsealed, suitably-sized, postage-paid, addressed envelope. These packages must be submitted
with the application to the Planning Department. They will be mailed by the planner to agencies aft r~/
project application is submitted. (~F(~c-' `E~
Top Portion to Be Completed by Applicant, Bottom Portion by Agency. APR 12 1999
i~iv~5i0n of Minerals & Geoa9Y
PROJECT NAME (from application package cover): G' 2 E EK P 17
Applicant'sName: ~ PNr ~ .L.~.v A~ G2~E~
Address: Ao 9 7 C . i2. I o0
/~esPe~2us e.oloiz.a~lo ~S13a(e
Phone: x'70 - S ~ 8 - 33 a S
SizeofPazcel: /U A.
Proposed # of Lots (if subdivision):
Proposed use (i.e. resid/e~ntial, commercial, etc.):
COY»Me1:Cial (3 /2HueI F:~f
Proposed Water Service: fJ
Agent's Name:
Address:
Phone:
Project Location: 7G ~ y C i2. /eD - ~o,e ~~.
y >„. asp i .,_ e,. /~«~ K~~~.
1 '
fo v, ~ s rglrl. <S<" y. 86y i ~d i~
Section: ~ Township: ~3 N Range: /~_W
Size, number & type of buildings proposed:,
~UN<
Proposed Sewer Service: ~.
Agency:
Agency Representative:
(Please Print)
Signature:
Please return comments within 21 days after receipt of this form to: La Plata County Planning Department
1060 East Second Avenue, Durango, CO 81301, [phone]
Pre-App Planner:
Pre-App Date:
(Applicant mud write in each agency an~`place forms in appropriate envelopes)