HomeMy WebLinkAbout1.00 Application FormGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
E OF SUBDIVISION/EXEMPTION
O Minor Subdivision
O Preliminary Plan Amendment
Major Subdivision
® Final Plat Amendment
O Sketch ❑ Preliminary 0 Final
Conservation Subdivision
O Yield 0 Sketch 0 Preliminary ❑ Final
O Time Extension
O Common Interest Community Subdivision
O Public/County Road Split Exemption
O Rural Land Development Exemption
INVOLVED PARTIES
Owner/Applicant
Name: RAN c k Pr'r cc u a as A-.5 S ° cs�T.� nl
CRE��c � � Phone: ( '170 ) 92-
Mailing Address: 11104 Cou&vT ( poAD 1 is
City: CF K30r1 oA t- State: CO Zip Code: R162-3
E-mail: rc-c- SDpriS.net
Representative (Authorization Required)
Name: (,cic1 Moa K
Mailing Address: 11$2 Cc..i+(e.
eeK
Phone: ( 57°) 3° Y-346 9
City: (,D.C6c:›ncick(Q. State: Co Zip Code: N62-3
E-mail: &k orr UNtt
PROJECT NAME AND LOCATIO
Project Name:
°LA o, � CD U-ee K Ro- PoAendmeat"
Assessor's Parcel Number: _ Mt -it \e. -
Physical/Street Address:
Legal Description: <e
Zone District: Property Size (acres):
�ro�ect escriptio,_
Existing Use: Pv ne{r. CA C re etc
Pw)
Proposed Use (From Use Table 3-403):
Description of Project: Re Moog. or ifcy. ci,o c 're vi -r1 c+; ..1-N
ev.-, Ptak-. .1
propose
Development Area
Land Use Type
# of Lots
Single Family
Duplex
Multi -Family
Commercial
Industrial
Open Space
Other
Total
N /A
# of Units
Acreage
Parking
REQUEST FOR WAIVERS
Submission Requirements
fl The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List:
Section: 4 - Lo 3 J DC__V "MT_ Section:
Section: 4-- 2-o j' k... S 1.0. Section:
Waiver of Standards
❑ The Applicant is requesting a Waiver of Standards per Section 4-118. List:
Section: Section:
Section: Section:
I have read the statements above and have provided the required attached information which is
correct and accurate to the best of my knowledge.
Signature of Property Owner
OFFICIAL USE ONLY
File Number:
24/16
Date
Fee Paid: $