HomeMy WebLinkAbout4106 Clayton Ct - Applications/Correspondence - 03/23/1983s�
BUILDING PERMIT APPL
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MAILING ADDRESS
NAME
Medema Homes, inc.
3665 JFK pkwy. #208
OWNER
CITY STATE
TELEPHONE NUMBER
Ft. Collins, CO 80525
226-5531
NAME
MAILING ADDRESS
Kurt Smeester
SAME
CONTRACTOR
CITY STATE
TELEPHONE NUMBER
226{il�3y�6 5g04S9.6� q
Lot # Block #
Squ
010
LEGAL
2 2
DESCRIPTION
Building Address
Name of Su division
Filing
Golden Meadows
3
Singe ami yXX - ex 3- ex
4-Flex Apt. Commercial
USE OF BLDG.
Public
Number of Units
TYPE OF HEAT
Gas xx
Elec.
Heat Pump
Baseboard
Radiant
Other
TAP SIZE
Water Tap Size 3/4"
Sewer Tap Size 4"
Metered IFlat Rate xx
STORM
Basin
�YG Ap-,r-�Q_6
Storm Drainage rea (�
I Zi 8?j �l *
DRAINAGE
Runoff Coefficient
B se Rate
Detention actor
Flood Plain
Yes No
5
3c?
70
UtilityFund—Number
Storm Dray age Basin . e
SIG �(o���
Li73. —�
Note: I understand that the Storm Drainage Basin Fee must be paid prior to the
issuance of a Certificate of Occupancy.
I understand that this application will
be handled as expeditiously as possible,
but that it will be at least 72 hours
before a permit can be issued.
Storm Drainage Utilityz�
Signature of Applicant:
Si nature of Buildin Ins nqct'
Date: 'Yld ? d' ;
Distribution Code: White -Building Inspection
Pink -Light & Power
Yellow -';Dater & Sewer Blue -Storm Drainage