HomeMy WebLinkAboutWA-11-03LAND USE CASE PROCESSING APPLICATION
Community Development Department
7500 West 29' Avenue, Wheat Ridge, CO 80033
Phone (303) 235 -2846
(Please print or type all information)
Applicant Colorado Lessor - Conifer, Inc.
CitV Hunt Valley
Address 200 International Circle, Suite 3500 Phone 4 427 -1726
State MID Zip 21030 Fax 410427 -8826
Owner Colo L Conifer, Inc. Address 200 International Circle, Suite 3500 Phone 4 10427 -1726
City H V State MD Zip 21 Fax 410427 -8826
Contact Stacey Love, NHA Address 6 270 W. 38th Street Ph 303421 -2272
City W h ea t Ri State co Zip 8003 Fax 303421 -1941
(The person listed as contact will be contacted to answer questions regarding this application, provide additional information when necessary, post
public hearing signs, will receive a copy of the staff report prior to Public Hearing, and shall be responsible for forwarding all verbal and written
communication to applicant and owner.)
Location of request (address): 6270 W. 38th Avenue, Wheat Ridge, Co 80033
Type of action requested (check one or more of the actions listed below which pertain to your request):
Application submittal requirements on reverse side
O Change of zone or zone conditions ❑✓ Special Use Permit
O Consolidation Plat O Subdivision: Minor (5 lots or less)
• Flood Plain Special Exception O Subdivision: Major (More than 5 lots)
• Lot Line Adjustment O Right of Way Vacation
• Planned Building Group Cl Temporary Use, Building, Sign
O Site Development Plan approval [Z] Variance/Waiver (from Section 26 -11/26 -502 )
13 Other:
Detailed description of
Required information:
Assessors Parcel Number: 39- 252 -00 -007
Current Zoning: Residential Three (R -3)
Current Use: Nursing H ome
Size of Lot (acres or square footage): 1.5 acres
Proposed Zoning: Residential Three (R -3)
Proposed Use: Nurs ing H
I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge
and that in filing this application, I am acting with the knowledge and consent of those persons listed above,
without whose consent the requ ste action cannot lawfully be accomplished. Applicants other than owners
must submit Dower- of- attorne $ro the oymer which approved of this action on his behalf.
Signature of Applicant_ `L ° _ '!
S scri ed and sworn to me this /h day of A�� `^ 20
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otary Public M Commission Expires 0;
My commission expires
To be filled out by staff:
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Date received ! ` / .// ( Fee $ -- Receipt No. CD4 J 0 5 , 7 32- Case No.
Comp Plan Desig. Zoning — 3 Quarter Section Map _ AL Ll 0 2S
Related Case No. Pre-App Mtg. Date T Z - 3 4 1 t Case Manager -rya.. 4--