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Cityy <br />`I Louisville <br />COLORADO-SINCE 1878 <br />Department of Planning and Building Safety <br />749 Main Street • Louisville CO 80027 • 303.335.4592 • www.louisvilleco.gov <br />LAND USE APPLICATION <br />APPLICANT INFORMATION <br />Firm: <br />Contact: L�Ot.+ t9 Ltip,Q.l <br />Address: 4a 4- La (5 t r l v t <br />LoutSville-t LA boob <br />Mailing Address: <br />Telephone: '303 - tD D is - 134-0 <br />Fax: <br />Email: e_tabe( CJ, tt 1 tom <br />OWNER INFORMATION <br />Firm: <br />� <br />Contact: (/„ 44 livt 7 bt r <br />Address: Sew a iopy6 <br />Mailing Address: <br />Telephone: <br />Fax: <br />Email: <br />REPRESENTATIVE INFORMATION <br />Firm: <br />I <br />Contact: 0i1.'l" 611 <br />, a 61. <br />Address: 5 Gbpvt,. <br />Mailing Address: <br />Telephone: <br />Fax: <br />Email: <br />PROPERTY INFORMATION <br />Common Address: 4 q 4 Lot 5 Drt v,L <br />Legal Description: Lot Blk <br />Subdivision <br />Area: (p4gei Sq. <br />Ft. <br />CASE NO. PY OLe <br />16 <br />TYPE (S) OF APPLICATION <br />❑ Annexation <br />❑ Zoning <br />❑ Preliminary Subdivision Plat <br />❑ Final Subdivision Plat <br />❑ Minor Subdivision Plat <br />❑ Preliminary Planned Unit Development <br />(PUD) <br />❑ Final PUD <br />❑ Amended PUD <br />U Administrative PUD Amendment <br />U Special Review Use (SRU) <br />❑ SRU Amendment <br />U SRU Administrative Review <br />U Temporary Use Permit: <br />U CMRS Facility: <br />U Other (easement / right-of-way; floodplain; <br />variance; vested right; 1041 permit; oil / gas <br />production permit) <br />PROJECT INFORMATION l <br />Summary-lDrll9 1aPilifl L vu Ree'[ For <br />Q Re5t d t f ft a I Lri- 41 4l1>, ai• cl r- 4 <br />foe fivbr addrhon of 431 5f bf <br />live 1 ava, 133 6i- of bvtrs4 <br />f rpt1port', rt/' 4- lVa5f art Gi.4 <br />Psw D"L4(D -b b atat 1'D stvi <br />4%40,14 Vivo 51•17r 5tnr lG rnti <br />'1 <br />r�e6t itja . y <br />Current zoning: Re. Proposed zoning: '+ <br />SIGNATURE, &, ATE c�P� — <br />Applicant: L�jf' ,J <br />Print: t-A4- v1 b <br />Owner: 4 <br />Print: " <br />Representative: II <br />Print: II <br />CITY STAFF USE ONLY <br />❑ Fee paid: <br />U Check number. <br />U Date Received: <br />