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Ij°I••••b1• ANNEXATION REVIEW Application Form Community Development Department An application must be received at least 30 days prior to the Planning Commission meeting. Date Filed: Amount Paid: File Number: Fax: E-mail Date of First Pre-Application Conference Fee Paid Date of Second Pre-Application Conference Fee Paid Required information to be submitted with this form: I. Petition for annexation signed by legal owners of the property within the area proposed for annexation. 2. Legal description of property requesting annexation. 3. 20 copies of annexation plan, folded, including required signature blocks for property owners, City of Lafayette, and Boulder County. 4. Submission shall include both a JPEG image and an 11” x 17” copy of each drawing. 5. A public hearing fee shall be included with all applications requiring a public hearing. This fee does not include the cost of publishing public notices or postage. 6. Mailing labels and funds for first class postage for all property owners within 750’ of the boundaries of the property requesting annexation and a list of those owners 7. Certification of Mineral Interest Notice completed. (See page 2 of this application.) to be sent 30 days prior to the public hearing before the Planning Commission. 8. Copies of the neighborhood meeting sign-in sheets as well as comment cards received by the applicant at the neighborhood meeting shall be submitted per Section 26-16-3(b). Complete the following: 1. Location of property requesting annexation 2. Current zoning of property 3. Proposed zoning of property 4. Zoning of surrounding properties: north south east west 5. Justification for requested zoning 6. Proposed and exiting uses of Pre-application conference(s) with the planning director or director’s representative is required prior to submitting an application. Fees associated with the pre-application conference must be paid at the time of the conference. An annexation requires a public hearing with the Planning Commission and City Council. If the request is approved by the Planning Commission, it will be forwarded to the City Council for a public hearing at the first available meting. If approved by the City Council, two readings of an ordinance will be required the City Council. The City will post your property and send letters to property owners within750 feet of your property ten (10) days prior to the scheduled meeting dates. The applicant or a duly authorized representative must be present at any and all public meetings to answer any questions raid by the Planning Commission or the general public. I hereby certify that I am the legal owner(s) of the abovedescribed property; that I desire to apply for annexation to the City of Lafayette and zoning of my property to and that the information contained herein is true and accurate to the best of my knowledge. Owner/Applicant Signature(s) Date Costs of Legal Notice in the Newspaper are paid by the Applicant AppI ication.Annexation ---PAGE BREAK--- CERTIFICATION OF NOTICE PURSUANT TO C.R.S. 24-65.5-103 The undersigned do(es) hereby certify that an examination of the records in the office of the County Clerk and Recorder was made in accordance with C.R.S. 24-65.5-103 et seq. and (check applicable box and fill in the information) D Thereafter, on 201, which is not less than thirty (30) days before the date scheduled for the initial public hearing, or, which is not less than thirty (30) days before the date of submittal of an application for staff action, on the application for the development known as notice was sent, by first class mail, to the below-named mineral right owner(s) as listed in the records of the County Clerk and Recorder, containing the time and place of the initial public hearing, or the date of submittal of an application for staff action and contact information of the Community Development Department, the nature ofthe hearing or staff action, the location and legal description of the property that is the subject of the hearing or staff action, and the name ofthe applicant(s). Listing of Mineral Right Owner(s): Name(s): Address: C Such records do not identify any mineral right owners. Development Applicant’s Signature Surface Owner’s Signature Print Name Acknowledgment State of Colorado) County The foregoing instrument was acknowledged before me this — day of , 201, A.D. by as Applicant of the property described hereon. Witness my hand and official seal. My commission expires Print Name Acknowledgment State of Colorado) County The foregoing instrument was acknowledged before me this day 201, A.D. by as Owner of the property described hereon. Witness my hand and official seal. My commission expires Notary Public Notary Public FAILURE TO PROVIDE THIS CERTIFICATION, INDICATING COMPLIANCE WITH C.R.S. 24-65.5-103 ETSEQ., IS LIKELY TO RESULT iN A CONTINUANCE OF THE HEARING OR STAFF ACTION. ---PAGE BREAK--- ANNEXATION PROCESS (Sections 26-16-3, 26-30) Pre-Application Conference > Application Submittal (Section 26-17) days PubtiSt O*nance City Council meeting hear resolution setting Ib a public hearing Additional Information lOdays Record with Boulder County Notes: Shaded boxes represent tasks completed by City staff. Squares represent public meetings or hearings. 60 day appeal period on any concurrent zoning. Estimated process time from application submittal to 2nd reading by City Council * To Planning Commission - 45 days * To City Council - 60 to 75 days