HomeMy WebLinkAbout01 ApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
LAND USE CHANGE PERMIT
APPLICATION FORM
TYPE OF APPLICATION
12 Administrative Review
0 Limited Impact Review
IM Major Impact Review
0 Amendments to an Approved LUCP
LIR DMIR p SUP
ID Development in 100 -Year Floodplain
0 Development in 100 -Year Floodplain Variance
ID Code Text Amendment
O Rezoning
Zone DistrictO PUD PUD Amendment
0 Minor Temporary Housing Facility
0 Vacation of a County Road/Public ROW
0 Location and Extent Review
0 Comprehensive Plan Amendment
0 Pipeline Development
0 Time Extension (also check type of original
O Administrative Interpretation
O Appeal of Administrative Interpretation
O Areas and Activities of State Interest
O Accommodation Pursuant to Fair Housing Act
ID Variance
application)
INVOLVED PARTIES
Owner/Applicant
Name: ,3p0,x-m-A.e... ,
Mailing Address: 2.2-L-1 cg, 51
City: ;eli),1-v?.)(\v)l
Phone: (alL) (pi g 52.5--(0
E-mail: LEN P' e sovr'Is .ne,-J-
State: -T-X, Zip Code: -7 (9 -1
Representative (Authorization Required)
Name: Sh Latjcre..
Mailing Address: 3 10 tAi-er 4ve_
city: Glefk vox,/
E-mail: ,c); 049 I/ OLo , Com
Phone: ( 97c) 987—L1
711
State: C-0 Zip Code: 81
PROJECT
PROJECT NAME AND LOCATION
Project Name:
Loy I err f‘e_ EriA51e- — $4,0; ve_
Assessor's Parcel Number:
Physical/Street Address: Zi 0 Cf) 2- 't
Legal Description: 6.0.
C41y-'fl w5+-
Zone District:
5 0 _ 1 QL
ik) e -vv C_AsH e_ ; C.4 8 i 617
5 al-kwi -2?-5 iti�ue 5 501A1
F
Property Size (acres):
0
PROJECT DESCRIPTION
Existing Use: 4 'I'l C_Oriinre._
Proposed Use (From Use Table 3-403): C a yy p re d v�if / RV I'� e i -- k
) ^c
Description of Project: 0 e /EIC Ci-CA.`S W'i c J i p pit 1/1/1)°4- i w
C_0441C
uviel?
()Meld—
o n 4, Ing p ceri a.. c4-cw, irX' ,0 A f-• t L4I tArD,1 / et/1R. b
Sf ' �7
REQUEST FOR WAIVERS
Submission Requirements
0 The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List:
Section: Section:
Section: Section:
Waiver of Standards
0 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 curate to thy knowledge.
Sig -tune of Pro
rty Owner,
Date
OFFICIAL USE ONLY
File Number:____-____
Fee Paid: $