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CITY OF FORT COLLINS, COLORADO
WATER & SEWER UTILITY"
PERMIT FOR WATER AND SEWER SERVICE
Name of Owner _
Address of Owner _
Description of Property
Bartran Nt>a11ss
1500 Quail Hollow Ft. Collins CO
Lot 7
Collindale 6th 6th Filing
1636 Coilindale Drive
Address of Property
Single Tanily without co..lon areas
Use
7,400 sq. ft.
Lot Area
Sewer A
Rate Category _
No 12179
286
THE fft AXRT, :4 HATER
PRESSURE AT THIS SITE
NAY EXCEED 90 p.s.i.
'"Tay=2�B6 c--: , •
Date
Account
Fees tit-,
Water UIF 3/6 1nch
502-43101
$1,928.00
Water Tap
502-42140
Sewer UIF 4 inch
503-43101
$1,600.00
Sewer Tap
503-42141
Water Right
502-43102
NP5634
Sanitation District
503-23204
LCL.,GJ
Sewer Repay
503-23204
Water Repay
502-23204
lot ent: 200,116 gal. Surcharge: tJo
TOTAL
$3,528.00
It is understood that before any work is begun, this bill must be paid in full to the Finance Department
(SEE ORD. 81, 1975). Taps must be activated within 120 days of validation date in accordance with Ad-
ministrative Policy A.d.
APPROVED:
Michael B. Smith
Director of Operations / Y/ (Applicant)
White - File Yellow - Owner Blue - Utility Billing
Green - Water Utility Pink - Building Dept.
Validation
'401jri. 920.90
IWI 'UFy 600 90
TDTL '52 a •30
CPC; 3,521, 'n
5.39 A