HomeMy WebLinkAbout1.01 Supplemental Application MaterialsGarfield County
NNEW
Building and Planning Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.oarfield-county.com
DIVISIONS OF LAND
APPLICATION FORM
INVOLVED PARTIES
Owner/Applicantp Q �// / 1�
Name: CLyD� -,n, i .. - 2 / 1/x//7 -bLC Ph ne �►
Mailing Address: T37—% im, L y
TYPEOF SUBDIVISIONS
State: flo Zip Code:
6>• CDM
TYPE OF EXEMPTIONS
--
❑
❑
--..
Sketch Plan❑
Preliminary Plan
❑
❑
Minor Exemption
Major Exemption
County Road/Public ROW Exemption
❑ Preliminary Plan Amendment
❑
W
Final Plan/Final Plat
Final Plat Amendment
❑
❑
Rural Land Development Exemption
Final PlatAmendment
❑
Conservation Subdivision Yield Plan
❑
Common Interest Ownership Community
fProject Name:
INVOLVED PARTIES
Owner/Applicantp Q �// / 1�
Name: CLyD� -,n, i .. - 2 / 1/x//7 -bLC Ph ne �►
Mailing Address: T37—% im, L y
City: -51 iii
E -mad: rn o I@�/4- 60
State: flo Zip Code:
6>• CDM
Representative (Authorization Required)
Name:
Phone: ( )
Mailing Address:
City:
State: Zip Code:
E-mail:
PROJECT NAME AND LOCATION
fProject Name:
Assessor's Parcel Number:
Physical/Street Address: J�
Legal Description:
/PI
i -Ci � 'c}-/ � �� • /►�• See_ �"�'
Zone District:
Property Size (acres):
Project Description
I Existing Use:
Proposed Use (From Use Table 3-S03):
Description of Project:
1 C + % /• e
Propose Development Area . ; .. .777777
Land Use Type # of lots # of Units Acreage Parking
Multi-Famill
Commercial
Industrial
Other
Total
REQUEST..: UUAIVERS
Submission Requirements
❑ The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List:
Section: Section:
Section: Section:
Waiver of Standards
❑ The Applicant is requesting a Waiver of Standards per Section 4-117. List:
Section: Section:
Section: Section:
I have read the statements above and have provided the required attached information which is
corre nd accurate to the best of my knowledge.
Signatur of Property Owner Date "'/cq'5-,
7
OFFI�IAI. USE ONLY `- _ -
Y
File Number:----.---- Fee Paid: $
Garfield County
PAYMENT AGREEMENT FORM/� p
D COUNTY ("COUNTY") and Propp�rty Owner ("APPLICANT") C.. ky0c DEC lo4T
2&AZ, 9 [iECVA % agree as follows:
1. The Applicant has submitte to the County an application for the following Project: vey-.5
2. The Applicant understands and agrees that Garfield County Resolution No. 2014-60, as
amended, establishes a fee schedule for each type application, and the guidelines for the
administration of the fee structure.
3. The Applicant and the County agree that because of the size, nature or scope of the
proposed project, it is not possible at this time to ascertain the full extent of the costs
involved in processing the application. The Applicant agrees to make payment of the Base
Fee, established for the Project, and to thereafter permit additional costs to be billed to the
Applicant. The Applicant agrees to make additional payments upon notification by the
County, when they are necessary, as costs are incurred.
4. The Base Fee shall be in addition to and exclusive of any cost for publication or cost of
consulting service determined necessary by the Board of County Commissioners for the
consideration of an application or additional County staff time or expense not covered by
the Base Fee. If actual recorded costs exceed the initial Base Fee, the Applicant shall pay
additional billings to the County to reimburse the County for the processing of the Project.
The Applicant acknowledges that all billing shall be paid prior to the final consideration by
the County of any Land Use Change or Division of Land.
I hereby agree to pay all fees related to this application:
Billing Contact Person: (' LVD E Dir E�2 T Phone: %) ,T / %S<5�
Billing Contact Address: 0877 O� C• 7-2-9
City: J,� �2` State: L-- Zip Code: SZ—
Billing Contact Email: C /7 A / 9/
Printed Name of Person Authorized to Sign: 12 L.L1/JC J/C (2 )16-4 7—
19A(Aiq DEc�FW 7-
S - Z.5-- X011
( ignature) (Date)