HomeMy WebLinkAbout3819 Benthaven St - Applications/Electrical - 07/07/1986P.O. Box 580
Fort Collins, CO
20342 CITY OF FORT COLLINS
Address
NOTICE OF BUILDING PERMIT APPLICATION
1
7'(a I
IIr s
PROPERTY
Subdivision orP.U.D.-Filing No. Lot No. Block No.
LEGAL
DESCRIPTION
Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
QZ-5 0
c�
Yes No
S"
Name
Phone
)l J
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CONTRACTOR
Address City State Zip Code
0 S
Name p ( j
L 1 d rc 6 F�
Phon Q 1
6 r V
OWNER
Address City State Zip Code
pTl 611, 11 s 8QS2_1
Single Family Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other;
TYPE OF
-
Heat Pump ❑ Baseboard ❑ Radiant ❑ Other.WATER - I
Gas N Electric ❑2
HEAT
AND
1
J/ (/
4
4- 'f�,'1c.,,
., ,.. ❑ O .
De Flat Rate
EWER
Water Tap Size:
Sewer TapSize:
Metered
Drainage Bas�inq
Gross Area 1
STORMWATER
ga a Rate
Runoff Coefficient
Detention Reduction Factor
Floodpikip
UTILITY
�+
'".�„'*z M.�'4.� �,
4.J �
� , "7 �,
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Yes No
I
fro be
Utility Fund Number
Storm Drainage B sin Fee
completed
by others)
� {S- 0
* " 1, y
Stormwater Utility Signature
1 �
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NOTE:
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Cer-
tificate of Occupancy. 1 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 Engineer, must be submitted to the Stormwater Utility for
approval before a Certificate of Occupancy will be issued.
Signature of Applicant:
Date:
DISTRIBUTION t• 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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