HomeMy WebLinkAbout1642 Collindale Dr - Applications/Single Family New - 11/11/1986CITY OF FORT COLLINS
P.O. Box 580
Fort Collins, CO 80522
NOTICE OF BUILDING PERMIT APPLICATION
Building Add.ress
PROPERTY
LEGAL
Subdivision or P .U.D.� A Filing No.
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Lot No._. Block No.
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DESCRIPTION
Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
7
Yes
% 5-
Names /1
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Phone
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CONTRACTOR
Address City State Zip Code
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Name
Phone
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OWNEROvY
Address 1 1 City State Zip Code
Single Family Commercial P Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
TYPE OF
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Gas.Od Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
NEAT
WATER AND
r^
ly
C/ "'
/
❑
SEWER
Water Tap Size:
Sewer Tap Size:
Metered Flat Rate&
f
Drainage Basin
Gross Area
t L1
STORMWATER
Base Rate
Runoff Coefficient
Detention Reduction Factor
Fioodplain
UTILITY
7#6 , ram
ref "
c,�
Yes No f
i
(To be
Utility Fund Number
Storm Drainage Basin Fee ttF1 -4 • =d i
completed
by others)
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t TDTL _49, 12
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Stormwater Util Signature
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NOTE: V
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Cer-
tificate of Occupancy. I 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 submitted to the Stormwater Utility for
approval before a Certificate of Occup cy will be issued.
Signature of Applicant: A� n
Date:
DISTRIBUTION 1. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer