HomeMy WebLinkAbout629 S Meldrum St - Miscellaneous/Building Inspection - 07/29/1996...1+'^ .:.•^w•--.�..... ....,� ;a�T'+'�:I�gSFY Y{7r'iT+P,1�N[. ••Fs�.Ti1Sl^ayyR'•'iFr'i,
Community Planning an nvironme
Building Permits and Inspection Division
CITY OF FORT COLLINS
BUILDING INSPECTION DIVISION
City of Fort Collins
I hereby authorize cancellation of said permit and/or plan review fee.
I further state that no work authorized by the above permit has been
done. I am requesting that applicable fees be refunded.
gnature Of Applicant'
Date
Permit Number Application Number
To Revenue Officer: You may authorize Payment in the amount of:
Tyne of refiind
15� Plan Review Fee 101-.341113
Permit Fee 101-322101
it
Sales Tax 90000
Miscellaneous r
Total Amount of Refund
Comm_ e_nts_ -�
I
AUTHORIZED SIGNATURE
*Attach copy of application or permit
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (303) 221-6760
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