HomeMy WebLinkAbout819 Columbia Rd - Applications/Single Family New - 01/28/1985CITY OF FOR s COLLINS
P.O. Box 580 '
Fort Collins, CO 80522 NOTICE OF BUILDI � G PERMIT APPLICATION 50
Building Address
PROPERTY
Subdivision or P.U.D. Filing No.
Lot No. Block No.
LEGAL
DESCRIPTION
oo
Lot Area
Corner Lot:
Total Street Frontage (lineal feet)
Yes No
/
Name
Phone .
CONTRACTOR
Address City State Zip Code
Name
Phone
OWNER
Address City State Zip Code
cAg, Igs O
Single Family Commercial ❑ Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
STJRM 106.2
TYPE OF
HEAT
IUIL AtJb9
CHM' 106.20
Gasf2l, Electric ❑ Heat Pump ❑ Baseboard ❑ Radiau� rfi
200,1
WATER AND
n h"
tl5
Flat Rate
SEWER
Water Tap Size:
Sewer Tap Size:
Metered❑
Drainage Basin
Cf &
Gross Area
(Q 067
STORMWATER
g se Rate
�
u
Run ff Coefficient
Detention Reduction Factor
Floodplain
TILtTY
t Lf� G a���
Q , (,�,s'
, `73
Yes No
(To be
Utility Fund N bar
Storm Drainage Basin Fee
completed
by others)
`-� Ip `
' J �O '� / �
lob,
Stor water Utility Signature
I`�"�
NOTE:
I understand that the Storm Drainage Basin Fee must be paid prior to the issuance of a Car-,
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'
APPLICANT
Colorado -registered Professional Engineer, must be submitted to the Stormwater Utility for
approval before a Certificate of Occupancy will be issued.
Signature of Applicant:�5�7
Date:
DISTRIBUTION t. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer