HomeMy WebLinkAbout3121 Moore Ln - Permits/Shed - 09/22/2006Community Planning & Environmental Services
r Building &Inspections Division
- P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofF phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS
PERMITTYPE
Last Name, First, M
w Address
Z
3
O Zip
Front Setback
Z Right Side Setback
z
OH Plat File No.
Subdivision/PUD
a
w Lot
J
ZBA Case Number Zoning DiE
Filing
Block Lot Area Parcel No.
Contractor License No.
Ae L
City/State
License No.
License No.
License No.
License No.
License No.
License No.
HOMEOWNER TO BUILD 18' x 30' POLE BARN
OWNER AFFIDAVIT ON FILE
BUILDING PERMIT 4
Building Valuation
B0601248 ACCOUNT FEE
PERMIT DATE
"- ""' "'n"' , Plan Check Fee
LEVEL CATEGORY TYPE
Qom' Building Permit w/o
ConsTrudion Type Occ ancy ouGT p
p No. of Stories Building Height P Ian Check Fee
OBuilding Square Footage Stock Plan/Opbons City Sales/Use Tax
EMISSION County Sales/Use Tax
REQUIRED•
CALL 221-6769 Stormwater PIF
TO SCHEDULE INSPECTIONS
(See reverse side for Inspection Description)
SBF FNB SPI
F I
As a ccpdition 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 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 or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced, suspended, abandoned or inspected within 180�from date sucermit from the date of the last inspection.
Print name of owner/agent Signature C/k Da TOTAL FEES
$52. 23
$80. 0
$0.10
$141. 5
$37. 0
$36.15
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