HomeMy WebLinkAbout2005 Evergreen Dr - Permits/Gas - Log, Line, Pipe - 10/29/1992DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
CountsA Fort BUILDING PERMIT
SITE ADDRESS 2005 EVERGREEN DR
PefuhA "`LOG/GAS LIGHTER
1E P`R`F9ftENTIAL
I
Subdivision ❑ PUD
Q subdivision/PUD
w
Lot —�
a
GO i ZIP 80521 Ph—cN4931255
RjTt"aWATER PLUMBING Convactoru"PelaP2
'M7 MCCALLISTER Oty FT COLLINS
80521 1 Phone 221_0905 Sale
ant Load
Dwelling Units
I I ZBA Case
upancy Separation
No. of Bathrooms Fin
61 f 8TTnRI —
7
Separation
As a condition for the issuance of a permit, I hereby declare that I am an owner
or the owner's agent, authorized to perform the proposed work on the property
described herein. I agree to comply with all the requirements contained herein,
and City ordinances, and State laws associated with such work.I understand that
such permit may be revoked in the event that issuance was based on incorrect
information. This permit shall become null and void if the work authorized by
such permit is not commenced, suspended, abandoned, or not inspected within
180 days from the date of such permit.
ro I Date
E FAMILY DETACHED
FINAL
iun, valuation
ACCOUNT FEE DATE PAII
BLDS PERMIT FLAT 15.00 9210-,
TOTAL FEES IS. 00
Fire Containment
Stock Plan Options
DEPARTMENT
SITE SETBACKS
REAR
LEFT RIGHT
FRONT
St Parking
CALL 221-6769
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
GL I LG I
AA
$15.00
$15.00
[AL - FILE, BLUE - OFFICE, CANARY - SALESTAX. PINK - APPLICANT. TAG - FIELD CARD