HomeMy WebLinkAboutADDRESS 133 Stanley Circle Dr NSFR 2022-06-30Received Date ar) /77. Town of Estes Park
Bauo
Received By
ASSIGNMENT OF ADDRESS
Community Development 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
General Info (970) 577.3717 • FAX (970) 588-0249 • E-mail: planninadlestes.org • erme.ostoson
Owner Name: Arkutxd
has been officially
Reason for change:
Parcel Number: 0 MOQC
Address: -di d 5 I di C i 40 Legal Description: A mall 6 Oa tK,„cz
y,,i,qI
6:i
(Lot) (Block) ract) (Subdivsion)
Phone #: 3)3 - - Email: ) ,v iIt 1'05
row .COlvii.
Fax #:
Mailing Address:
City:
CA St,
State:
OWNER'S SECTION:
I am officially requesting my current address,
0.11) NU( CS IS
be changed to
Preferred Contact: [7] Phone L Fax
I certify that I am the legal owner of said prop rty.
I kill lk Q.' A Usk
Print Name
Signature
Owner responsibilities ar on the back side of this sheet
Date
Office Use Only
Zip Code:
10!]
1 '<1/"'
Effective Immediately the current address, d
alai/ea •
jtfJrnoy
Email
Building Officia( Date
Tech
4.4
Path Page 1 of 2
LlComm DevlAddressFiles11.AddressChangeslAddress Change Application.doc
Fee
Total
100.00Ihour (one hour minimum)
$ 0.00
Revised 7/18/2019
)
\
\ 1
} /
(/II :\< °
� \ Z