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HomeMy WebLinkAbout01.0 ApplicationCommunity 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 ■ Rezoning ❑ LIR ❑MIR ❑ SUP ❑ 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: (-5e- )Ll (Lk)k4 -1 I 1 �av'�,{`, Phone: (203 ) 6,1q-4(014 0 Mailing Address: 44 REt. L1 )0 (7 til oI2 City: C,k9_1c' +v Ok tI State: Zip Code: 8 L G X-5 E-mail: Ki - -t' LL -1,1A 1A. -SC (-- A- A. C4(1)(2.�. CC9-'. Representative (Authorization Required) Name: iU ( /} Phone: ( ) Mailing Address: City: State: Zip Code: E-mail: PROJECT NAME AND LOCATION Project Name: A kA - CC zs5 ae y Dvcre (-Li s— lA i t Assessor's Parcel Number:p�73 6 - J 5 4- © 1- 0 O B 14z3 Physical/Street Address: L-4 RE -12, i I-) 4 LA -r0 E G4az8a,oba fin-, 60 , Legal Description: 1-OY LI 14 A la) bL4C Sr uSO 1 U t S 10 AD Zone District: R ute_A L. Property Size (acres): 6, 0 q PROJECT DESCRIPTION Existing Use: IZOS[kZ;oTIAL Proposed Use (From Use Table 3-403): We_ L -L-1 J 6 l,& K5 ; T l\ c' Cc -.56:,(2_;.../ Description of Project: 3 u i L f) a N .4 b Lc(&o- rzoc u 4-1- i 5 et reAo,z / "I� A -T -'c L -3 L.E.,G .S -% r i ,�Z �'� 2i �.i k R- 5 i 314 /Z©o m s. 1 3/`l IST 14 or -F-1 c r (5 -rt, 14 1 4 -c - ,v cp i— ano it -1t. . REQUEST FOR WAIVERS Submission Requirements IL The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List: Section: i4 - cebei'10„s ci) Section: Section: Section: Waiver of Standards 21. The Applicant is requesting a Waiver of Standards per Section 4-118. List: Section: '7 — l tJ Section: Section: 7 - /0 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. 5” nature of Property Owner :3— /4— 20/6 Date OFFICIAL USE ONLY File Number:- Fee Paid: $