HomeMy WebLinkAbout822 Merganser Dr - Permits - 09/19/2000Building &Inspections Division
ghCommunity Planning Environmental Services BUILDING P E RM I 'PERMIT
FEES
P.O. Box 580 281 N. College Ave.
Building Valuation $450.00
Fort Collins, CO 80522-0580
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BOLD 15674
phone (970) 221-6760 Fax (970) 224-6134
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ACCOPNT
FEE
DATE RAID.
JOB
SITE ADDRESS 822 MERGANSER DR F?CO
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PERMIT DATE
09/19/2000
Binding NITRO: WiSubs
$15.00
09/19/200
PERMIT
TYPE
ELESER Electrical Service Change
PERMIT LEVEL
ISSU_FUL
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CATEGORY TYPE
TELEPHONErrELEGRAPH SYS
Last Name, First, Middle Initial
Construction Type
Occupancy Group
QUEST COMMUNICATIONS
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Z
Address
Ciry! Stale
p No. of Stories
Building Height
3
12680 WCR 58
GREELEY, CO
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Zip Phone
80634
No.
Building Square Footage Stock PIaNOp[ions
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Front Setback Rear
Setback
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Z
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Right Side Setback Left
Side Setback
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Z
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Plat File No. ZBA Case Number
Zoning District
(See reverse side for Inspection Description)
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Subdivision/PUD
Filing
FNE EG
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wLot
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Block Lot Area 0 Parcel No.
Name Contractor License No.
OCompany
Address City/State
Phone Supervisor Cert. No.
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Electrical License No.
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TRI-CITY ELECTRIC It ME-344
GMechanical
License No.
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Roofing
License No.
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Framing
License No.
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yPlumbing
License No.
100 AMP SERVICE FOR FIBER BOX
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As a
described
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
herein. I agree to comply with all City ordinances, and State laws associated with such work. I understand that such permit ay be revoked in the
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event
that issuance was based on incorrect or incomplete information. This permit shall become null and void if the work authorized by such permit is not
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commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit or from the date of the last inspection.
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Print
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name of owner agent Signature Dat
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