HomeMy WebLinkAbout409 Peyton Dr - Applications/Reroof - 08/25/2011City f Planning, Development & Transportation
y o281 N. Coilece Ave P.O. Scx S80
ort Cot -tins For' Collins, CO 80524
Phone S 70-41^-2740 . Fax 224-5 134
OVER-THE-COUNTER PERMITS ONLY
T'nis application is to be used to apply for the following permits only (check all that apply). C Air Ccnci�ioninS
C Cemoiiticn (interior nor.-5,-.cturzl) G ciect^cal Alteration (nct savioe charge) C:, Gas Lighter Gas Log
C Heating Unit C Lawn Q'Pnnkler L Mobile Horns r9oiacsrT.ert `: Roofing 0- .Sewer Line ❑ Phoic-voltaic
C Ven lation C Water *Etter - Waiar Line ❑ ' `/codl"PEIISI SiCvs (must be -rA. certified., provide makes, modci End
rl an of actu re r) •
Complets all applicable information on the applica-cn, lncompiets arpOcations will not be accepted.
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Property OW, --Er Name Address
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Appllc3nt Name _ AdCress
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r`cnc 70
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germs DQ WtnclSor Co S'4550
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Con raac`cr City cf Ft. Collins Sall i aX x
Ar you paying Lxes her or by r 2perr?
-Ere 0 Report
Sala
Are you paying witm your t
YES C No
A C70 s(D
Is "tiis a residentia! or r/c�7o�r�n-;merdal pro ec`_? PKEsident;ai ❑ Conneru'ai
.. IfraSid�. rii_ah IS It: w�IryrlE =amity De:ac ed ❑ Ccrid�/tVW111 .Vrl�i (STCIE i`cr-liy aµ=C"led) ❑ CUpleX
0 M\\ul"`-oily (apai�err) ❑ Garage
lr C'orrrne-u2i, is it: ❑ Dark ❑ Bar ❑ CnUrCn ❑ HCt21/MCLe1 ❑ iv'"criiC=i CGiCE ❑ Cf iU ❑ Rat5i!
❑ Fas�urant ❑ Other (Expl21 )
Is this building So years of age or r..cr=_? C Yes No i`ya: you J772yrE_d ro cor.4adri_4orc P, sort/cG'Gr
If this is fcr a demolition permit, what ye?r was the bulking constructed?
If prior Co 1975, you wlll need 2/1 sutlwlt W%u7 67%5 Fri%2�'Cr1
Ct
*lf I2wr spinkler/cactiCw WE/eni.er, r„uF, ;'ist Iicn-nsed -,-lurter, if A/C, r-e5 list dCerS2= 3'eZriCar:-
Subcontractors: L'si &,e or Coy cfF= Colllrs lrcorse
epc'ridan Number Gone!
I heraby' ad<,Ir vt(edCa trlat I have read ti is ap Rce-Gn and sty 9 t-az i1a a_cve JrfQr:7aLon is Ccc,,fete ano =ram. ! acre_ tC
Ccrapiy WiLn all rECCIramertz cznu-inEd- her2i I c.nd Cit/ v -fi trances a^C saL2 laws ecdEtnic-l'ilCin;C CJnst uc'_on �. I know that a
permit is not valid until It has be=_n paid and is;tled,
Applicant:
Print Name=: ii'Q �Ct�� Siena Data a✓
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