HomeMy WebLinkAbout5114 Stetson Creek Dr - Applications/Reroof - 08/26/201108/26/2011 00:36 FAX
m 012/027
Planning, Dendopnmd & TM .. portartlon
281.N. College Ave P.O. SM 560
Fort Coluns, Co e0524
Phone 97"16-2740 Fax 22+6134
OVER-THE-COUNTER PERMITS ONLY
Thin application is to be used to eppN for the following pennies only (check all that 2PP1Y)• 0 Air Conditioning
Q Demolldon (interior non-sinxrtural) . ❑ Mechicai Alteration (not service change) ❑ Gas Uahter 0 Gas Lop
17 Headnp Unit D Lawn Sprinkler Co Mobile Home replacement ) ReoMg 0 Sewer Line 0 Photo-voltdo
0 VentllWon 0 Water Neater ❑ W&W Line Cl WoodlPellat Stove (must be EPA certified, provide make, model and
manufacturs0.
Cornplees all Wpllcablb Information on the sopIlaalion. In mplsls applicaRlerhe will not be aCCOptbd.
AppAcat4on # � Date
For cu>nts rm a*
Job SfILe AddMW (M40=0
prop" CWMW Name
z havia
AppNeant Name
Value o5 CD"1bVWIT (labor, materials, prom
$ --7LFn0•n
Address city/ C) Zip
Address GLy/SDbe Ti- lC i l e 1 S rip
Contractor Uc a Address
Contractor City of FL diSinns Salsa Tu S
JWWornrl7l0 & fi3&nd1braffCVn&8C&VM
�wnw.r 410-17
CitY/sr+m".CNAVIS ZIP
phone
CJ� 311
52-4 Phone
a3. 2
5 2 4 Phone
Are you paying tw= here or by report? $-Hgre ❑ Report
Are you paying with your trust eacounV 0 Yes 1�00
Is this a nt Waidal or Wrhmerdal proled? 041e61d nilai k7 Comnm Wl
If redderrtsal, Is s p singb Au" batethed Condo/ Dwnhom (single %mtly atttched) C3 duplex
C1 MuWantiA� (aWrtMer� GOra9e El Medical ofltae 17 OftiQ 0 Retdtl
If=mrnardal, so it: 0; Bank D Bar 0 Church 13 Motal/Mooct
13 AA taurant a other (expw)
Is Ws bulkIng ao y=* oil •w or morn? o Yaa W4XQ JFX* YW �r 'peed to Qanbd N/�tw�t T7iWWWbb
If ails Is far a dwaan m parpi ly whao Year was the building CWUftMW
1Ppriar ab 1975, yvu wall reed an asbssbas a /+mtt to Agin R WrYb ddr ap ftwa -
offwalc
*If fawn sprlNdar/tlKW W prevarrter must Bat llcarrsed plumb W. 11 firsmWie NC, must IWC 30005e0 .• W sup'.
cum LN & Lnl►ip6l�' name W ' aaFR
Mdr..a.r RoOfp 1=10.�J--� Oft
pymt7er
n and tivt the abe+re (rdormatton 1s a Mplam and GorreCC 1 age to
I tw cby adawwladge libel I have read this application laws rbfm*W ixrilding mnWtuedon. Y iaww thet e
canPN v+esI all rwAranw►t; centamad herein and dW Ordlnancet and stets
Is not v&W mtte it has been P*N abd bishhe L `