HomeMy WebLinkAbout5931 Boyne Ct - Applications/Single Family New - 11/19/1984CITY OF FORT COLLINS
Pc0. Box 580
Fort Collins, CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
'mot �(-p
Building Address
'i -.. O h.l e M U \4,
PROPERTY
Subdivision or P,U.D. Filing No.
Lot No. Block No.
LEGAL
DESCRIPTION
j� j
U> i \ 1+J G t'O � t i �l S
Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
eL
Yes No
Nam
Photone
„OAj CCONTRACTOR )h.
'
— to J
Address City State Zip Code
{I /y
Name
Phone
1�`/%tv
OWNER
Address City State Zip Code
Single Family � Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
TYPE OF
HEAT
Gas 1K Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑
Other:
1WATER AND
SEWER
Water Tap Size:
WZjap Size: _ -T
Metered ® Flat Rate ❑
.
Drainage Basin
Gross Area
S RMWATER
U iTY
Base Rate
Runoff Coefficient
Detention Reduction Factor
Floodplain
Yes i No
(to be a
others)
Utility Fund Number
Storm Drainaqgellaei,17
.
Stormwa er Utiilty Signature
NOTE:
1 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
VLICANT
Colorado -registered Professional Engineer, must be submitted to the Stormwater Utility for
.'
approval before a Certificate of Occup�anc❑/y_will be issued.
- --
Signature of Applicant: [ *_K Ri-'Y�� � r✓t
Date:
t. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer