HomeMy WebLinkAbout1.00 Garfield Country ADU Land use application[IC:Garfield County
Community Development Department
108 81" Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www. arfield-count .corn
LAND USE CHANGE PERMIT
APPLICATION FORM
TYPE OF APPLICATION_
❑
-- — -- — - —
Development in 100 -Year Floodplain
❑
Administrative Review
Limited Impact Review
❑
-{
Development in 100 -Year Floodplain Variance
❑
Major Impact Review
[3Code
Text Amendment
❑
Amendments to an Approved LUCP
❑
I
Rezoning
❑ Zone District❑ PUD ❑ PUD Amendment
❑ LIR ❑MIR ❑ SLIP
❑
Minor Temporary Housing Facility
❑
Administrative Interpretation
❑
Vacation of a County Road/Public ROW
❑
Appeal of Administrative Interpretation
❑
Location and Extent Review
❑
Areas and Activitie;ofStatle Interest❑
Comprehensive Plan Amendment
❑
Accommodation Pto Fair Housing Act
❑
Pipeline Development
j ❑
Variance _
❑
Time Extension (also check type of original
application)
INVOLVED PARTIES
Owner/Applicant s v p
Name ofl.�lA Phone: ft -0) f
Mailing Address:
city: AJOrsi State:1 zip Code:
E-mail:
Representative (Authorization Required)
Name: Phone:
Mailing Address:
City: ? State:_ Zip Code
E-mail:
_PROJECT NAME AND LOCATION ----
Project Name:
-7 - uP
pv-
Assessor's Parcel Number:
Physical/Street Address: Lilt o (.L.,vIrrH 17 2
Legal Description: /A)_PIn) c2r'TOt /"I- &VOL;�1
Zone District: ejk j Property Size (acres): ��1.
PROJECT DESCRIPTION
Existing Use'
Proposed Use (From Use Table 3403):
7
1 Description of Project- _A-1
Fki6Q6UiEiSTf�FORWA VERS
submission Requirements
per Section 4-202. List:
of Submission Requirements
requesting a Waiver
The Applicant r Section:
Section:
Section:
ection;
Waiver of Standards
0 The Applicant is requesting a Waiver of Standards per Section 4-118. List:
Section:
ection;
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.
LV -_ --7 - -1
Signature of Property Owner Date
OFFICIAL USE ONLY
File Number: — — --- — — — Fee Paid: