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HomeMy WebLinkAbout1605 Collins Ct - Applications/Reroof - 11/05/201211/05/2012 16:18 19702241211 ROCKY MTN ROOFERS PAGE 01/02 Pam,. Development t Thnupoetation p 281.14, College Ave PA. Box 5134 o Phone 97"16-27W Fax 224-6134 OvER—THIE—COUNMR PERM= ONLY Thies appaca* a its to be used to apply for the fogovleM p only (O=k 20 that spy.. 0 Ah- f omMoning t] Dem01 Um (in dckr nmm&udurWl Cl EWCVKW Aiima�. (riot.erica oho igay 0 Ow Lighter' Q. Gas Log O Pleating Unit 0 Lawn spdrdder 0 M bOe Hmie rapboernerd 14leg © sewer line 0 Photo -voltaic C, Venffl&b re 17 Wrier lamer L3 Wafer Line 13 W (outd be EPA cerfiffiecl, provide make, model and manufrn knar). Complete an appuicaele 'e d 3e, appftcfon, kumnWjeta appUcafimis win not be _ Rarer wu ox* tbo7 AddFeM �(�a' # value pry (l�, �, irk) .-is c.17- f S0 Property owner Nam Addmsa Q zip shone aJ t ci- CIA41C So o f e uez-hi L( !W & Fat ofHo - / Applicant Nam Address C tl 41) Phone Contractor Uc s g- ► 713 Address zip Phone yotov'P. �otK47 ,v l aal r� 5.4 Ler a�1-Let�i•'� $e.fd� a�tF—l�oo Contractor aty of rL cams Sates Tax # Are you payfeg tom here or by report? © Here Report sabsur awnIw.&fiVtedbya8.� Are YOUpdyls VAth VMF UlZt a=fflt? 14 Yes ❑ NO 7 06 -. -.+.cam :.. '� I •+ •- � a. 'f'� '.:. s. ^� >y,' f'• '„�. •,. • rl �f ,- �.!• .il�.a c. � 1' t,.'a •f o- s =. ■ ::: t. , f : -I ■ .. r ■ .re. 'eZT • .� s.J t'f^ .e 1 t_" tl• - -wt a w♦ ! •GJ Ya If. ir:•a +Yt' .'f:/ f � L fl � _J I•ii..,: • — , i ..1 � 1 •� f I �i ,f •R ry il' f mid J' /- JJ . a, _.l -�I' ti`J:-::,- .�1':..1.` f1 :J:Y '( of> TQt44 of% 12oef &aWN *If jam sWtdderfbaddkAv , mLst fst #=u*d phfrber. If fgst-titrte /yc, rracst Hst f a n- > I heme6y aduwWWW old I twm erael Fins men and sty!teat the Dbove Wnrut&M is acid mrrect I agreeto a m �� and ord mKps mid sUte jaws regc Mi j ft&bV air► x Iee w beat a has bow APPg 1e '� 2 ! ! L gL r► per{/ [�