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C�Tyis" <br />"Department of Planning and Building Safety <br />Lville <br />COLD ADO -ZINC)' 1749 Main Street , Louisville CO 80027 • 303.335.4592 • www.louisvilleco.gov <br />ELECTRONIC LAND USE HEARING REQUEST CASE NO. <br />APPLICANT INFORMATION <br />Firm: <br />Contact: <br />Address: <br />Mailing Address: SC�re <br />Telephone: <br />Fax: \ ,� <br />Email � V ,t\5QC'— •DU( '0' , O\N'\ •C <br />OWNER INFORMATION <br />Firm: <br />Contact: <br />Address: D SS <br />( nusk � tte� CP '�noa�- <br />Mailing Address: <br />Telephone: 4-2q) <br />Fax: <br />Email: <br />REPRESENTATIVE INFORMATION <br />Firm: �` C�� ���„�� i�L C <br />Contact:C <br />Address: <br />Mailing Address: <br />Telephone: <br />Fax: <br />Email: <br />PROPERTY INFORMATION <br />Common Address: LQ- CC'X a(kQ (Z . <br />Legal Description: Lot Blk <br />Subdivision <br />Area: Sq. Ft. <br />TYPE (S) OF APPLICATION <br />❑ Annexation <br />8�— Zoning CVj 7 C, C% 4A\—) <br />❑ Preliminary Subdivision Plat <br />❑ Final Subdivision Plat <br />❑ Minor Subdivision Plat <br />❑ Preliminary Planned Unit Development (PUD) <br />❑ Final PUD <br />❑ Amended PUD <br />❑ Administrative PUD Amendment <br />❑ Special Review Use (SRU) <br />❑ SRU Amendment <br />❑ SRU Administrative Review <br />❑ Temporary Use Permit: <br />❑ CMRS Facility: <br />❑ Other: (easement / right-of-way; floodplain; <br />variance; vested right; 1041 permit; oil / gas <br />production permit) <br />I hereby request the public hearing(s) on this application be <br />scheduled to be conducted by Electronic Participation in <br />accordance with the attached Resolution No. 30, Series 2020, <br />as adopted by the City Council on April 7, 2020, if such <br />hearing(s) can be scheduled during a time period when in - <br />person meetings are not being held due to a health epidemic <br />or pandemic. I acknowledge that holding a quasi-judicial <br />hearing by Electronic Participation may present certain legal <br />risks and involves an area of legal uncertainty, and that <br />having this application heard at a meeting held by Electronic <br />Participation is optional and undertaken at my own risk. I also <br />understand that in -person meetings are preferred for quasi- <br />judicial hearings, and that even if electronic hearing(s) are <br />scheduled, this application will be heard at an in -person <br />meeting if in -person meetings have resumed by the <br />scheduled hearing date(s). I further agree to defend and <br />indemnify the City of Louisville in any action that may arise <br />out of, or in connection with, conducting the hearing by <br />Electronic Participation. <br />SIGNATU S <br />Applicant: J <br />Print: (_ a— <br />Owner: <br />Print: <br />Representative: — �%LQ <br />Print: <br />CITY STAFF USE ONLY <br />❑ Electronic Hearing Approved: <br />❑ Date(s) of Hearing(s): <br />