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Document Elbertcounty-Co_doc_898b1946a1

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Phone: (303) 621-3101 Address: 221 Comanche Street, P.O. Box 26, Kiowa, CO 80117 Email: [EMAIL REDACTED] Website: Radius Report Application Date: Property Owner: Phone: Applicant (if not owner): Phone: Schedule # or Parcel ID or Subdivision and Lot: Contact Info: Email Address: Area (LFT): 500 1320 Note: There is a $25 charge for this report. This covers the cost to develop the radius report and map. The results with be sent via the method indicated in the “Contact Info”. Paid: Yes No Note: If payment is not received at time of application submittal, an invoice will be sent. Report will not be sent until payment has been received. Print Name Signature ELBERT COUNTY OFFICE OF THE COUNTY ASSESSOR