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pall C.,0U ng Hgodandal Energy Code
Ualidon Discloswe Form
M-t'i'PlfeabL- N P STAR or ENERGY =RE U*411 O0)
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The buitding & zoning ftt. of
Community Plumitfg and Enrtr=>rueninl Savift
211 N, Cnilege Arc, P.O. B" $Aa, Fad Collins, CO SOS22
vatic: 970 224 6134 Fast 970 224 6134
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1%s dj4,,later foral 1% to be3 signed by ft ImoUlullan contmdar or t0prMAMU ve of Ilia general 001aetaN
Pl"&a type or print, crAD* tar ft ejgnature. Complete this InforrPeAlon in the approp►iete cPgcas provided.
if compments Yet), makb muldple erttrles to deecrlba them.
One copy of th1d form must to provittod to the Building arw zoHng Deperttnent prior to the C.O,
Oils topy of thla 1=1 phist be mad available to the anginal hoire buyer,
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