Land Use Approval Compliance Page 1 Applicant Date: Owner Agent First Name: Last Name: Phone: Cell Phone: Fax: Email: Address Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Is Mailing address different form address? YesNo Mailing Address Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Page 2 Property Subject to Application Click here to name this section Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Parcel #: Practical Property Description: Acreage or Square Feet Parcel: Existing Zoning: Present Use of Property: Proposed Use of Property: Proposed Floor Area Ratio: Proposed Building Height: Proposed Lot Coverage: All structures on the property) Proposed Setbacks: What Proposed Setbacks: Front Rear Side(a) Side(b) Explain what side of the house side (a) is on- North, South, West, East: Explain what side of the house side (b) is on- North, South, West, East: Page 3 Are Property owners Different form applicant? YesNo 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: Proposed Needs Description of Proposed Request (Please list each request separately [e.g. zoning compliance, land use approval compliance, etc...]: Is this: Complete Incomplete Comments: The Application Shall Include Accurately Scaled Drawings or Provide Other Information Correctly Depicting the Following: 1) Structures, Utilities &, Improvements The location of all existing and proposed buildings, utilities and other improvements on the property.: Is this: Complete Incomplete Comments: Structures, Utilities &, Improvements - Drawing: 2) Parking The location and number of parking spaces for off-street parking and loading areas and the finished surface material of the parking areas (e.g., gravel, asphalt), Is this: Complete Incomplete Comments: Parking - Drawing: 3) Traffic Plan A traffic circulation plan showing the direction of traffic flows and indicating the locations of entries and exits of parking lots and the relationships of parking lots to entrances and exits of any buildings, Is this: Complete Incomplete Comments: Traffic Plan - Drawing: 4) Refuse &, Services The location of service and refuse collection areas. Is this: Complete Incomplete Comments: Refuse &, Services - Drawing: 5) Signage The location of all signs indicating the size, shape and height of each sign, Is this: Complete Incomplete Comments: Signage - Drawing: 6) Parkland Dedication The area and location of parkland dedication areas or cash in lieu, Is this: Complete Incomplete Comments: Parkland Dedication - Drawing: 7) Exterior Lighting The location and type of outdoor lighting including photometrics, Is this: Complete Incomplete Comments: Exterior Lighting - Drawing: 8) Landscaping Landscaping plan showing the location, type, size, and quantity of plant materials, method of maintenance, irrigation systems, fencing and other features. Is this: Complete Incomplete Comments: Landscaping - Drawing: 9) Improvements Completion Date(s) The estimated date of completion of all improvements. Is this: Complete Incomplete Comments: Improvements Completion Date(s) - Drawing: 10) Public Improvements Utilities, street improvements, right-of-way dedications, easements etc...(May include Subdivision Improvements Agreement) Is this: Complete Incomplete Comments: Public Improvements - Drawing: 11) Referral Agency Requirements Referral Agency Requirements: Is this: Complete Incomplete Comments: Referral Agency Requirements Select Referral Agency: Town Engineer Town Attorney Water Attorney Other -1 Marshal Water/Wastewater Fire District Other - 2 Mesa County CDOT Xcel Energy Other - 3 Public Works Explain Other -1: Explain Other -2: Explain Other -3: Page 4 Additional Information 12) Impact Fees - Traffic Impact fee and any other required: 13) Tap Fees - Water &, Sewer Tap Fees 14) Water Rights Dedication - Description of water rights dedication or cash in lieu 15) Architectural Design Compliance - Building elevations and other information showing compliance with architectural design standards 16) Engineering Design Compliance - Engineered drawings demonstrating compliance with DeBeque engineering design requirements and DeBeque Public Works Design Standards 17) Trustee Approval Conditions Compliance - Attach all conditions of approval required by the Town of DeBeque in association with approvals granted for the subject property and demonstrate compliance thereto 18) Payment of Development Review Fees - Show verification of payment of all fees associated with application approval including, but not limited to, application fees, consulting fees or others 19) Payment of Use Tax - Show verification of payment of all use taxes associated with construction. Fees are payable at the time of building permit issuance Authorization Applicant Signature: Date: Applicant Signature: Date: Need assistance with this form?
