HomeMy WebLinkAboutEVERGREEN PARK BLOCK 3 LOTS 13 AND 14 - Filed DCP-DEV. CONSTRUCTION PERMIT - 2003-07-31DE . ELOPMENT CONSTRUC , iON PERMIT
APPLICATION
City of FuR Collins
For City use only: Application Number: A033-00 Application Date: 8.16.00
Permit application fee: $150.00
INSTRUCTIONS:
1. Complete this form (some questions may not apply to you) and attach all
necessary documents and submit to the Development Engineering Section
of the City.
2. Contact Tim Blandford, Development Review Engineer at 970/221.6750
and/or e-mail: tblandford(d-)ci.fort-collins.co.us, if you have any questions.
3. Submit the Application and pay the Application Fee at the Engineering
Counter, which is located at 281 North College Avenue.
PROJECT INFORMATION:
Project Name (as approved by the City):
Evergreen Park, Block 3, Lots 13 & 14
Project A.K.A. (Marketing name if different from Project Name):
Schrader Propane Tank
Project Location:
Property Owner (At the time of this permit issuance):
Individual
Company
Address:
Phone number(s):
Office: (47c) LI-- 12Z 5
Cell:
Fax: (c'l7ci)�
Email:
Applicant/Project: Manager (The primary contact person for all matters regarding this
project, and the pE+rson responsible for all matters referencing "the Developer" in the
Development Agreement for this pr��L
Individual Name: �y ►-►��
Company Name:
Address: L= 7 Avg,- \ F=
Phone number(p
Office: X,
Cell:
Fax:
Email:
DtVELOPMENT CONSTRUC TION PERMIT
APPLICATION
('itv of f'ort Collins
For City use only: Application Number: A033-00 Application Date: 8.16.00
Permit application fee: $150.00
INSTRUCTIONS:
1. Complete this form (some questions may not apply to you) and attach all
necessary documents and submit to the Development Engineering Section
of the City.
2. Contact Tim Blandford, Development Review Engineer at 970/221.6750
and/or e-mail: tblandford(aD-ci.fort-collins.co.us, if you have any questions.
3. Submit the Application and pay the Application Fee at the Engineering
Counter, which is located at 281 North College Avenue.
PROJECT INFORMATION:
Project Name (as approved by the City):
Evergreen Park, Block 3, Lots 13 & 14
Project A„K.A. (Marketing name if different from Project Name):
Schrader Propane Tank
Project Location: t3Cr ge�D e�'i p �=
Property Owner (At the time of this permit issuance):
Individual Name:
Company Name:
Address: 3z7e,� �- E
Phone nurnber(s):
Office: 07c!) JSe -- 12Z 5
Cell:
Fay::
Email:
Applicant/Project Manager (The primary contact person for all matters regarding this
project, and the person responsible for all matters referencing "the Developer" in the
Development Agreement for this project):
Individual Name: fFX!r
Company Name: �_ tr �_,�E�,�;�'__ ��,� CEO ,� 1�8rA-t
Address:
Phone nurnber6-x,)
Office:
Cell:
Fax:
Email:
Project Engineer (A Colorado licensed professional engineer who is the civil engineer the
person responsible for the design of this project, responsible for certification that
improvements are constructed in accordance with approved plans, responsible for making
revisions to plans, with Cit approval and for providing as -constructed plans):
Individual Name: —-
Company Name: a
Address: l kl P y z-3 lhy - 1,j
Phone nurnber(s):
Office: (R?v)
Cell:
Fax: (q1 W ,�*i 2ozz,
Email: te a« U t�k 3rch,+e_cA-s, cx+
<_
Developer (The party or parties referenced in the Development Agreement who are
responsible for the Developer's obligations contained in the Agreement —add additional
names below):
Individual Name:
Company Name: C
Address:
Phone nurnber(s):
Office:
Cell:
Fax:
Email:
General Contractor (The contractor in overall charge of the public infrastructure
construction):
Individual Name:
Company Name:
Address:
Phone nurnber(s):
Office:
Cell:
Fa:x:
Email:
If you have no General Contractor, list all other contractors below.
Grading contractor:
Individual Name:
Company Name: _
Address:
Phone nurnber(s):
Office: _
Cell:
Fax:
Email:
Utility contractor: NA
Individual Name:
Company Name: _
Address:
Phone nurnber(s):
Office:
Cell:
Fax:
Email:
Concrete contractor for flat work:
Individual Name:
Company Name:
Address:
Phone number(s):
Office: cF2,- Lss,f
Cell:
Fax:
Email:
Concrete contractor for structures: NA
Individual Name:
Company Name:
Address:
Phone number(s):
Office:
Cell:
Fax:
Email:
Paving contractor: tJA
Individual Name:
Company Name:
Address:
Phone number(s):
Office:
Cell:
Fax:
Email:
Landscape contractor:
Individual Name:
Company Name: _
Address:
Phone number(s):
Office:
Cell:
Fax:
Email:
Other contractors and parties involved in the project:
SUBMIT THE FOLLOWING ITEMS (Required for all projects):
• 81/2"x11" copy of the Site Plan
■ Proposed Project Schedule
■ Project quantities and cost estimate for all of the public improvements to be
constructed. In addition, include all private improvements that are required to be
inspected by the City Construction Inspectors. This information must be submitted in
the format shown on the attached form titled "Project Quantities and Cost Estimate
Sheet."
ADDITIONAL SUBMITTALS (Required if checked):
Traffic control plan(s) for the project
Proposed haul routes shown on a City map
Shop drawings
C Other:
CONSTRUCTION COORDINATION MEETING: A construction coordination meeting to
discuss plans and special requirements for your project is required for all development
projects. The people required to attend the meeting are the Project Manager, Project
Engineer, Developer, Architect/Land Planner and General Contractor (if no General
Contractor, representatives for each of the contractors expected to work on this project)
People to Attend: List the people's names and their respective title for those who
will attend the pre -construction meeting:
Name Title
ESTIMATED COST OF INFRASTRUCTURE IMPROVEMENTS: Provide the estimated
value of all public infrastructure improvements that will be constructed and accepted by the
City to own and maintain. In addition provide the value of all private infrastructure
improvements that the City will inspect and require certification for. The estimate shall be in
the same format as the attached sheet titled "Project Quantities and Cost Estimate Sheet."
Public infrastructure estimated cost: $ 4X_�>1
Private infrastructure estimated cost: $ il,F_
I certify that the information on this permit application along with the required additional
submittals are true and correct to the best of my knowledge, and that in filing this application
I am acting with the knowledge, consent, and authority of the owners of the property
(including all owners having legal or equitable interest in the real property, as defined in
Section 1-2 of the City Code; and including common areas legally connected to or
associated with the property which is the subject of this application) without whose consent
and authority the requested action could not lawfully be accomplished. Pursuant to said
authority, I hereby permit City officials to enter upon the property for purposes of inspection
and, if necessar/, to enter upon such property to perform work required of the applicant if
the applicant were to foil to perform the required work.
/.J
Applicant Signature: �lJ Date: L2,voc
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