HomeMy WebLinkAbout3807 Benthaven St - Applications/Other - 05/15/1986CITY OF FORT COLLINS
P.O. Box 80
Fort Collins, CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
Building Address 1[
380 % Sen_//� 4,&rt,
PROPERTY
Subdivision or P.U.D. Filing No.
Lot No. Block No.
LEGAL
/ bN ✓ Se 1J0 v S�
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DESCRIPTION
Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
Faso
Yes No
Name 1 l/ �
CO/Oh IL �phl//G,G7 �0� CL
Phone
1 V
CONTRACTOR
Address Code
'/ �yJ // rCit / /State pZip
3J T 9. ///(s/Z / v �//h4 Lb Ulis.�
Name
Phone ,
OWNER
S'� Me
Address City State Zip Code
Single Family ® Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -'Family ❑ Other:
i
TYPE OF
HEAT
Gas ® Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
WATER AND
Water Tap Size: 3/y„
y
Sewer
Metered❑ Flat Rate®
SEWER
Tap Size:
Drainage Basin} ( $ (
Gross Area
STORMWATER
Base Rate
Runoff Coefficient
Detention Reduction Factor STORH 2`
i ,)�oodplain
UTILITY
�a
�.+� t
az o
IITG
t73
es No 1
(TO be
Utility Fund Nu ber
Storm Drainag fFLe29 °i=, `. A
by others)
.dcompletedtit�. {),,.,
�` t:
6 r»dxRa
Stormwat r 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
Coloradorregistered Professional Engineer, must be submitted to the Stormwater Utilityfor
approval before a Certificate of Occupancy will' be issued.
Signature of Applicant:L��7.tJ'1'
Date:
DISTRIBUTION
1. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer
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