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• TO: TELLER COUNTY PL~ING DEPARTMENT <br />- P, O. BOX 1886 <br />L~700DLAND PARI:r COLORADO <br />90863 <br />PHONE: 687-3048 <br />FOR DE~TMENT USE: <br />File No.: <br />Date Filed: <br />Filing Fee Recd: <br />Plan Submitted: <br />No. of Copies: <br />APPLICATION ~R O]NDITIOiIAL USE PERDLT <br />$? ~0.0o TELLER COUNTY, COLORADO <br />Legal Description of Subject Pr petty:~ <br /> <br />Statement of Request: <br />Total Acres: <br />Reason. <br />,oy.J ~~ - .~c.E~Zpt-d'ir~t. <br />I hereby certify that I am the applicant named herein and that I <br />have familiarized myself with the rules and regulations with <br />respect to preparing and filing this petition and ;hat the <br />foregoing statements and answers herein contained and the <br />information on the attached map are in all respects true and <br />accurate to the best of my knowledge and belief. Fur•,hermore, l <br />understand and agree that I am responsible forthe ccmpletion <br />of all site improvements as ap roved by the Planning Commis- <br />sion on the fi al plat.. <br />Signed. 7 ti4.:.2~ L Dare: <br />Owner or Authoriz d Representative <br />FOR OFFICIAL USE ONLY <br />Reviewed by: <br />Planning Commission Action: <br />Date <br />~ ~ 12)-, ~5-~` <br />- - (3) <br />Comments: <br />Present Zoning <br />Statt Report Date <br />Action <br />t ~ <br />/ , <br />l~.J .....; ~ t-Fr.~~ <br />~~~I - ~ f~9~o Home <br />Agenda Date: <br />Date Notified <br />Name of Petitioner(s): ~~>7 irJnuS of e~~ PPL~ ~~ ~ M I ^~ ~ NCT ~o. ~.Jr/ <br />