Annexation &, Resolution of Substantional Compliance Page 1 Applicant Date: Owner Agent First Name: Last Name: Phone: Cell Phone: Fax: Email: Mailing List Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Is there a Co-Applicant? Yes Co-Applicant (If Necessary) Month: Please select...JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year: Please select...19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015 Owner Agent First Name: Last Name: Phone: Cell Phone: Fax: Email: Mailing List Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Page 2 Property Subject to Application Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Parcel #: Existing Zoning: Acreage or Square Feet Parcel: Surrounding Zoning North: West: South: East: Practical Property Description: Legal Description: Description of Annexation Request: Present Use of Subject Property: Uses Surrounding Subject Parcel North: West: South: East: Page 3 Property owner(s) *If different from applicants Owner 1 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 2 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 3 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Current list of adjoining and abutting property owners to the subject parcel obtained from the Mesa County Assessor\'s Office. Owner 1 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 2 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 3 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 4 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 5 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 6 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 7 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 8 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 9 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 10 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Page 4 Proposed Needs Description of Proposed Utilities, Access and Other Infrastructure Needs: Complete Incomplete Comments: The Application Shall Completely Address each of the Following Items: Justification for annexation. Please clearly state the basis upon which the proposed annexation is made: Complete Incomplete Comments: Designation of the Property in the DeBeque Comprehensive Plan. Identify the applicable classifications or descriptions of the property and recommendations for use, density or other requirements specified in the DeBeque Comprehensive Plan: Complete Incomplete Comments: By typing your name you are Authorizing an E-signature Applicant Signature: Date: Applicant 2 Signature: Date: Need assistance with this form?
