HomeMy WebLinkAbout1636 Collindale Dr - Applications/Single Family New - 11/24/1986CITY OF FORT COLLINS
P.O. Sox 580
Fort Collins 'CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
ouuamg Acidness
i� C-v %f � � r -
DROPERTY
_EGAL
Subdivision or P,U.D. Filing o.
J� / ' /J
Lot No. Block No.
DESCRIPTION
/ 1 rr, (� �—I
Lot Area
Corner Lot:
Total Frontage (lineal feet)
Yes
/Street
�✓
Name
O V Ya
Phone
Z 23 - L IJ
CONTRACTOR
Address City State Zip Code
) 1')w -/'
"5VP f
Name �
A
Phone
2 2-3- z� a�
b �;✓_,- I.-
OWNER
State Zip Code
Address City P
)
Single Family Commercial ElNumber of Units:
USE OF'
BUILDING
Multi -Family ❑ Other. ,
TYPE OF
Gas t$ Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
HEAT
WATER AND
/
((��,,��
Flat Rateiz
SEWER
Water Tap Size:
Sewer Tap Size:
Metered❑
Drainage Basin
Gross Area
STORMWATER
Base Rate
Runoff Coefficient
Detention Reduction Factor _
Fioodplain
UTILITY
"F,7Qtt acresx
- r
Yes No
Re be
Utility Fund Number
Storm Drainage Basin Fetra. }
NQ a?
completed
by others)
cr
.tAffi^'x%&i's
at79 ,
j
Stormwater Utility ignature
.__
TOT
NOTE:r-
1 understand that the Storm Drainage Basin Fee must be paid6fffSrt6 tfie is'suahce of a Cer-
tificate of Occupancy. 1 further understand that if drainage improvements are required for
this site, two (2) copies of a drainage report and a drainage plan, signed and stamped by a
APPLICANT
Colorado -registered Professional Engineer, must be submltt d to the Stormwater Utility for
approval before a Certificates ofOccu ancy,will be issu d
Signature of Applicat:(�'t�� J
Date: Z
DISTRIBUTION t. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer