HomeMy WebLinkAbout918 Bramblebush St - Applications/Correspondence - 08/03/1988CITY OF FORT COLLINS
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P.O. Box 580
Fort Collins. CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
Building Address I
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PROPERTY
Subdivision or P.U.D. - Filing No.
Lot No. Block No.
LEGAL
DESCRIPTION
X
471/r-{n.`/f)t
/
Lot Area
J�
Corner Lot:
Total Street Frontage (lineal feet)
Yes No
Name
Phone
CONTRACTOR
Address City State Zip Code
/
/- 7
Name Pho
Sip E
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OWNER
a TRI
Address City State` Zip Code
AIWS
' �0 0 t►T
bffi
tica` o��
Single Family 0 Multi
-Family
USE OF
BUILDING
OEM
Commercial ❑ State Type of Bu i
(Refer to Code Sheet)•.-,
TYPE OF
❑1 Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
HEAT
Gas
WATER AND
%r!
1�
Metered ❑ Flat Rate❑
SEWER
Water Tap Size:
Sewer Tap Size:
/ S
Drainage Basin
Gross Area
STORMWATER
Base Rate
Runoff Coefficient
Detention Reduction
Floodplain
Utility Fund Number j
UTILITY
factor
Yes No
f
(To be
Stormwater Utility Signature
Storm Drainage Basin Fee
completed
by others)
STREET
Signature
Date
OVERSIZING
Fee
(To be completed_
by others)
Fee to be waived ❑
NOTE: I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a
Certificate 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 Occupancy will be issued. '
Signature of Applicant:
f
Date:
DISTRIBUTION I t. Original:Applicant — Z Gold: Stormwater Utility —3. Blue : Transportation Utility— 4. Green: Street Oversizi ng
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer