HomeMy WebLinkAbout3419 Carlton Ave - Applications/Single Family New - 05/15/1986-CITY OF FORT COLLINS
P.O. Box 580
Fort Collins, CO 80522 NOTICE OF,BUILDING. PERMIT APPLICATION
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Building Address
3
PROPERTY
Subdivision or P,U.D. Filing No.
Lot No. Block No.
LEGAL
DESCRIPTION
/ 1 (�
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Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
98 �i
Yes ®
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O 01
Name
Phone XX
Oa S
�Z ZG Ud
CONTRACTOR
Address City State Zip Code
Nam
Phone
S
u3- zZ�u
,
OWNER
Address . City State Zip Code
5 r
f�
Single Family Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
TYPE OF
S QF hy,Dr
Gas o Electric. ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
HEAT
WATER AND
y
❑ Flat Rate
SEWER
Water Tap Size:
Sewer Tap Size:
Metered
Drainage Basin �L
Gross Area
STORMWATER
Bise Rate
Runoff Coefficient
Detention Reduction Factor
Floodplain
UTILITY
L 714
„ (
yG—
Yes No j
(To be
Utility Fund Nu ber
stein Fee i
Storm Drainage
completed
by others)
SIC L(,j tw(,f +76-
l
fin
0 I
Stormwater Utility Signature
NOTE:
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Cer-
tificate of Occupancy. I further understand that if drainage improvements are required for
this site, two (2) copies of a drainage report and a drainage plan, signed and stamped by a
APPLICANT
Colorado-registered.Professional Engin er, must be submitted to the Stormwater Utility for
approval before a Certificate of O p cy will be iss d.
r
Signature of Ap lica
Date: S r
DISTRIBUTION 1. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer