HomeMy WebLinkAbout2818 Bluegrass Dr - Applications/Single Family New - 07/25/1985P.O. Box 580
Fort Collins, CO 80522
/ CITY OF FORT COLLINS
NOTICE OF BUILDING PERMIT APPLICATION
5-5zr7
Building Address 6M5-'s
PROPERTY
S`uubddivision or P. .D. Filing No:
Lot No. Block No.
LEGAL
w �� A T
33
DESCRIPTION
Lot
�
Corner Lot:
tage (lineal feet)
Total Street Frontage
9
Yes No
t/
1e
Nal..-E L-44%T
P ne 91OfiM�6�3/39
CONTRACTOR
Address City^ St8f1TL 4 35 Zip Code
fl09258 08=47 A
Name AUG
,Rh'brilF,
OWNER
Address City State Zip Code
Single Fami le25Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
TYPE OF
HEAT
Gas l,27�r Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
WATER AND
'�j �L
44—i 1
❑ Flat Rate ❑
SEWER
Water Tap Size:
Sewer Tap Size:
Metered
Drainage Basin ty
Gross Area
i
1
STORMWATER
g se Rate
Runoff Coefficient
Detention Reduction Factor
Floodpla'
UTILITY
�}�
V .,
Yes No
(ro be
Utility Fund Number
Storm Drainag Basin Fee
by opthers)
!
Stormwater Utility ignat`�re
,
I
NOTE:
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Cer-
tificate of Occupancy. I further understan that if drainage improvements are require8 for
this site, two (2) copies of a drains re rt a a drainage plan, signed and stamped by a
APPLICANT
Colorado -registered Professional g' er, st be submitted to the Stormwater Utility for
approval before a Certific f an will be issued.
Signature'of Appicant:
Date:
DISTRIBUTION t. Original: Applicant - 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer