HomeMy WebLinkAbout400 Lilac - Permits/Water and or Sewer - 11/15/1988City of Fort - Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 4ymG
Name
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Mail Address 40c> G (�
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Phone 41q3 —
Name '�
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Address/s' ✓/ ��E
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License No. %fff%
Phone el.—i
Contractor Sales Tax No. /,?0 73
0
Lot Block
Filing Number
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Subdivision
PUD
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Parcel # Oo�
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
1 hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
o npp and state I s rreegguulattii'ng, buildingconsqucction.
signed U date
- — CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elect Struct. fire Prot.
❑ ❑ ❑ \ ❑ ❑
Dec. Gr, Type Conss
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Dec. load
Occ. Change from
Plat File No.
No. D.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric,Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot -❑
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1 l I 1
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JLL
Street
PFt;.TS 35.00
TOIL S5.C8
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a N99243 12=38 A
ZBA Case # Date
BE A Case # Date
Building Insp. I/_ Approval
by �J date
3 3�7,�;
11 �1 s
Permit No.
Date
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Distribution: Original - Applicant. Blue - Office. canary - Sales Tax: -Pink - Applicant; Tag
Beta (nap.