HomeMy WebLinkAbout1742 Deweese St - Applications/Single Family New - 10/16/1986P.O. Box 580 CITY OF FORT COLLINS
Fort Collins, CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
Building Address
11 ub.. t" d
PROPERTY Sdivi ion or P.U.D. Filing No. Lc
r, LEGAL
DESCRIPTION M
Lot Area
Corner Lot: I Total Street Frontaae
ICONTRACTOR
I' OWNER
USE OF
BUILDING
Name
Address
Name
Address
Single Family
Multi -Family ❑
Yes No
Commercial ❑
Other:
NO.
Phone
ne
Number of Units:
Zip
i
TYPE OF
HEAT
Gas ❑ Electric ❑
Heat Pump ❑ Baseboard ❑
Radiant ❑
Other:
WATER AND
SEWER
Water Tap Size: /
Sewer Tap Size: /'
Metered ❑ Flat Rate ❑
Drainage Basm
Gross Area
STORMWATER
Base Rate
l e"
De#en#Ion
oduction
Factor
Ffoodpla n
UTILITY
k *riK
L..a"+�rusl K
Yes No
(To be
Utility Fund plumb
r
AT Tr#AkA9F
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raj
agd3a31n F13@
completedAA=1
by others)
Stormwater Utility
Ign #�
t
ATE
G4
AflY 0"5 10HATION _—
NOTE:
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Cer-
tificate 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: >
Date:
DISTRIBUTION 1. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer