HomeMy WebLinkAbout725 Columbia Rd - Applications/Single Family New - 06/14/1985CITY OF FORT COLLINS
P.O. Box 580
Fort Collins, CO 80522 NOTICE OF BUILDING PERMIT APPLICATION
PROPERTY
LEGAL
DESCRIPTION
I CONTRACTOR
I OWNER
USE OF
BUILDING
TYPE OF
HEAT
WATER AND
SEWER
Subdivision or P.U.D. Filing No. Lot No. I
Lot AreaQ `� Corner Lot: Total Street Frontage (lineal feet)
U'Q UV Yes o rr)5
Name Phone
D
Address City State 2
16 a3 Sa wa} &�((OLLS 30
Name ,() ` Phone
hA
i �.a���3jjjlll �e►� y `Fel I itis Ca v
Single Family LEI Commercial ❑ Number of Units:
Multi -Family' (❑ Other:
I
QTnQM ! �A t o
TDTL 124.12
Gas Electric ❑ Heat Pump ❑ Baseboard ❑ Radiant ❑ Other:
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Water Tap Size: Sewer Tap Size: Metered ❑ Flat Rate ❑
s
Drainage Basin
�r G
Gross Area
STORMWATER
g e Rate
Runoff Coefficient
Detention Reduction Factor
FI odplain
UTILITY
o_"
0 ,4Je—,
0 ,_7�
Yes No
(To be
Utility Fund Number
Storm Drainage Basin Fee I
by Others
510 • �7 � t�
, -�.
C Z� `!
Stormwate�Uttility Signature
V�r ,
NOTE:
APPLICANT
I 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
Colorado -registered Professional Engineer, must be submitted to the Stormwater Utility for
approval before a CertificateA Occupancy will be iss%Wcl.
Signature of Applicant:
Date: l L 4,L_,
I DISTRIBUTION 1. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer