HomeMy WebLinkAboutMS-95-5The City of
ADMINISTRATIVE PROCESS APPLICATION
Wheat
Rid a Department of Planning and Development
b 7500 West 29th Ave., Wheat Ridge, CO 80033
Phnna !3031 237-6944
..rr--_-__. --___ .._ - - _-. _.- - -. _-
Owner l ~ GiS ~~nt/~ ~-Address / Phone --
Location of request yy„3a /~1 G~~ S~`
Type of action requested (check one or more of the actions listed below
which pertain to your request.)
Change of zone or zone conditions
Site development plan approval
Special use permit
Conditional use permit
emporary use/building permit
inor subdivision
Subdivision
8 Preliminary
Final
[~** See attached procedural guide
for specific requirements.
Variance/Waiver
Nonconforming use change
^ Flood plain special exception
Interpretation of code
Zone line modification ----
Public Improvement Exception
Street vacation
Miscellaneous plat
Solid waste landfill/
mineral extraction permit
^ Other
~;
I certify that the information and exhibits herewith submitted are true and
correct to the .best of my knowledge acid that in filing this application, I
am acting with the knowledge and consent of those persons listed. above,
without whose consent the requested action cannot lawfully be accomplished.
Applicants other than owners must submit power-of-attorney from the owner
which approved of this action on-his behalf ~
Sign ~ P Applicant ~; ;;~~~fg
;~~2i~s-~ and sworn to<~~ this
.. f~~. ~ ~ - -.. _ ___ .A"G
da,~ of ~~, 7.9 ~.
W
My commission expires ~Q'Q3'G/.S
Receipt No.
Case No.
List-.all persons and companies who hold an interest in the described real
property, as owner, mortgagee, lessee, optionee, etc.