HomeMy WebLinkAbout1.00 Application
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
Administrative Review Development in 100-Year Floodplain
Limited Impact Review Development in 100-Year Floodplain Variance
Major Impact Review Code Text Amendment
Amendments to an Approved LUCP
LIR MIR SUP
Rezoning
Zone District PUD PUD Amendment
Minor Temporary Housing Facility Administrative Interpretation
Vacation of a County Road/Public ROW Appeal of Administrative Interpretation
Location and Extent Review Areas and Activities of State Interest
Comprehensive Plan Amendment Accommodation Pursuant to Fair Housing Act
Pipeline Development Variance
Time Extension (also check type of original application)
INVOLVED PARTIES
Owner/Applicant
Name: ________________________________________________ Phone: (______)_________________
Mailing Address: ______________________________________________________________________
City: _______________________________________ State: _______ Zip Code: ____________________
E-mail:_______________________________________________________________________________
Representative (Authorization Required)
Name: ________________________________________________ Phone: (______)_________________
Mailing Address: ______________________________________________________________________
City: _______________________________________ State: _______ Zip Code: ____________________
E-mail:_______________________________________________________________________________
PROJECT NAME AND LOCATION
Project Name:
_____________________________________________________________________________________
Assessor’s Parcel Number: ___ ___ ___ ___ - ___ ___ ___ - ___ ___ - ___ ___ ___
Physical/Street Address: ________________________________________________________________
Legal Description: ______________________________________________________________________
_____________________________________________________________________________________
Zone District: ___________________________________ Property Size (acres): __________________
PROJECT DESCRIPTION
Existing Use: __________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Proposed Use (From Use Table 3-403): _____________________________________________________
Description of Project: __________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
REQUEST FOR WAIVERS
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 4-118. 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 or Authorized Representative, Title Date
OFFICIAL USE ONLY
File Number: __ __ __ __ - __ __ __ __ Fee Paid: $_____________________________