HomeMy WebLinkAbout316 Del Clair Rd - Applications/Reroof - 06/03/2013From Affordable Roofing Inc 1.970.207.0289 Mon Jun 3 15:29:04 2013 MST Page 2 of 2
Ct4.;tGTg. Planning, &Transportation
281 N. CU!legetlow P:O. tiox.5E3p
Fort CoIEmS, CO UW24 pA
': •:-:: '>.`.: Phone 97P-4i6-2740 Fax:224-6134 16
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OVER-THE-COUNTER PERMITS ONLY
rj This app0eetion is to be used toapplq'or the EolA7wing parinit6 only (cheek all that aPP1Y1- E_l'gi:Cnnditiorti: cg
DemoEitton (inLri0. ron•stmircYurd!) Cl iectrical Alterafion. (Fiat a1e�rtvics'changeI C] Gas Ligtiier (� Gas e
O Healing Uni[ G lawn Sptlnkter c7 Wtdttife tlolne ntptacerrwe.t X Roofing ❑ Saw z Lure ❑ Photo-voEtaio
13 Uyn!ifatilut 0 Water Heater tJ Water Line (;1 YVoodlpelet Steve {mucl be EPA r�rt(fed, pro Ph to-vo model and
manufac,^turar).
Complete ag applicable information on the apPllcat(on. Incomplete aPolicationc will not be accepted.
Application awnDate I
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Value of ( ---' . Co+rut'trction tat:sr, materiatc, Gnxit)
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rrx,ao+tt�e: is Are you NON taxes here u by report? .Q I re. U Rfgtott
rft+uw l:Y -- ------ axr, Are you payiny m4tn your trust acrnunt� 0 Y. p No
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e Is obis a resiGsidai w corrir.Tercial aojecx?-'----- .FTRasidmiiat ❑ Carrmerciat "�...--.�.
(Y res(dendal. is k: w Stn�* Family oewUred i7 Condaj[owrtllortat (single FarNly nttatiie9
Q MulbYarnRy (aphgmem) Q (;araw, ) C, wpiex
if aanrherrcat, L• it: 0 Baru 0 Far ❑ thurcFt D Hotel/Pto!el [; M . -;,, oftice ❑ C)'fice ,7 Re ❑ RG,faurant [7 tri'he (2,>:utain; laC
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is thS ttltilcting So years of age or mom.? CI Y� L) Nc Jf yRr,_ -------- ad ro a r.Yacl hfiSeplrcl3itZYy�(jyt
If this is fcr a demolition pormtt, N4tat wi r was the tiuild:ng co:i- :ctr.C't .._
lfR%, r di Y9:5 }'rtu lrk'ne..rfsn a_� a��s.srmot to scLmit KgbtLts � -- -•---------•-`�.
Descttp(ioRofl'Jpt{ , a6.Y(FC'G ' ([^
'rIr%awn spriniciar/hectMav prevetXer, mus4tist licen>-ect --..�-�-- i pkrmixtr. Ii firms -firm µ/'C meet tlst ?ICEnSsc ctactriGtan.
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I hereby arlrUtwtetlgP. tlmaY (SITYe lead t11[e applicttSon and 5tpt`: that ilea erxT•IQ t(lfnrmsUon.is Q>mplC;o EnU— ••—
comply wkh 811 reaurements Comitained hrnV,� and U!q ordinances and state laws regulatlng biUUing constnrcrarrem lI a r e to
permit Is not valid until It has been. paid and tssued
Applicant: A :....:. _._..... signstuPrHtt Name.,
.r...._�_....... —Date
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