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Lcity.! <br />Louisville <br />COLOR.IE ., • 51.:CE 18:d <br />Department of Planning and Building Safety <br />749 Main Strum • Louisville CO 80027 • 303.335.4592 • www.loaisvilleco.gov <br />LAND USE APPLICATION <br />APPLICANT INFORMATION <br />Firrn: <br />'contact: <br />Address: <br />Mailing HdDress: <br />I elepdprie' <br />Pax: <br />Email: <br />PROJECT INFORMATION 1 r j <br />3ummary:�rDi (rY b c + <br />., e* 5 (Ai <br />OWNER INFORMATION <br />Firm: <br />Contact:pe (;01)1e <br />Address: (\ 7`/? (,Or /Sye <br />C,�G Lov151,;1(or, gam .1 <br />po <br />Mailing Address: <br />#141 7 <br />1 elepnone: 72 27,22. -o31 <br />Fax: <br />Eu;I: I 4. 'CJAC:0 r <br />- <br />REPRESENTATIVE INFORMATION <br />Firm: <br />Contact: <br />Address: <br />Print: 6, of ( x <br />Mailing Address: <br />Owner. J� <br />Telephone: <br />Fax: <br />Email: <br />PRUPERTY INFORMATION! <br />' (n} <br />Common Address: 71q W r (cQ e wq <br />Legal Description: Lot 4. Blk <br />Subdivision rr' ern Pini.ta 4 <br />Area: 1121 K Sq. Ft. <br />t.A�E IQV. <br />TYPE (S) OF APPLICATION <br />0 Annexation <br />0 Zoning <br />O Preliminary Subdivision Plat <br />❑ Final Subdivision Plat <br />0 Minor Subdivision Plat <br />❑ Prelimi..arx Planned Unit Do;clopm cit <br />(r0u) <br />0 Final POD <br />0 Amended PVD <br />0 Administrative POD Amenuument <br />❑ Special Review Use (SRU) <br />O SRU Amendment <br />O SRU Administrative Review <br />❑ Temporary Use Permit: <br />❑ ,CMRS Facility: <br />Other: (easement / right-of-way,; floodplain; <br />variance; vested rigni; i'uAut permit; oil r gas <br />production permit) <br />PROJECT INFORMATION 1 r j <br />3ummary:�rDi (rY b c + <br />., e* 5 (Ai <br />D <br />141. ?(1•17.0T47 A , )e - <br />i `j4'4e)(;�'y C L,+ii L o(.t7h <br />)•-e>, 11 ere eS u <br />_5-1/144-4-i <br />1,14 10 e491,--, c -,,-.I -f! <br />r <br />,v ms <br />1 Lvs!" .25 yet,rS <br />Current zoning: Proposed zoning: <br />SIGNATURES & DATE 1 <br />Applicant: <br />Print: 6, of ( x <br />Owner. J� <br />Print: ,('r Ge�- <br />Represen.a'ive: <br />Print: <br />CI I T STAFF OSE ONLY <br />0 Fee paid: ----- <br />CI CPicuR nrarnder: <br />D Date Received: <br />