HomeMy WebLinkAbout600 Marigold Ln - Permits/Gas - Log, Line, Pipe - 10/30/1995Community Planning & Environmental Services
Building Permits & Inspections Division
P.O. Box 580
Cftvof Fort Collins Fort Collins, CO 8052M580
)B SITE ADDRESS cnra M oTr nl n I iJ
UILDING PERMIT
221-6769
FAMILY DETACHED
use Zane Permit L"I
Pmpo ed use
NA
Subdivision ❑ PUD
Filing
PERMIT FEES
J
�SubdiHsion/PUD
Building Valuation
W
300
J
Lot
Block
Parcel Mo.
-
ACCOUNT
- - - -
FEE
DATE -DATE PAID
Lest
First
M.I.
ad
DANIEL
BLDG PERMIT FLAT
15.00
W
Z
Add..
City
3
60 RIGOLD LN
FORT QQLLTNS
0
State
lip
Phone No.
CO
80526
5
Company Name
contractor Uwme No.
FRIENDLY FIRE
Address
City
State
UiJ
co
Phone Solos Tax No.
Olip
u
8052 4 -
Nd
Ocoupont Wad
C
O
3
No..1 Dwelling units
No. of Bed,
LL
O
Ted
o
GAS LOG INSTALLATION
Ea_
a
u
N
W
0
As a condition for the issuance of a permit, I hereby declare that I am an owner or the
owner's agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and City ordinances, and State
laws associated with such work 1 understand that such permit may be revoked in the event
that issuance was based on incorrect information. This permit shall become null and void if
the work authorized by such permit is not commenced, suspended, abandoned, or not
inspected within 180 days from
�the'date of such permit.
ISignalure(rt/cJV� Date / p 30 0
TOTAL FEES
SETBACKS
REAR
LEFT
FRONT
Amu
RIGHT
TO SCHEDULE INSPECTIONS
(See reverse side for Inspection Description)
GL I LG
j DEPARTMENT -STATUS DATE'
Eledncul
OTC PERM T ISS N/A
_ N/A
Plumbing
,> g N/A
a m Fm