HomeMy WebLinkAbout917 Camelot Ct - Permits/Duplex New - 02/24/1984City of Fort
,,. - � � T xr ram,,..-.v.-.,c,_...�-.,_,_`� - - - ,�,�v,..�,-,.�•,;:,-_;�4.,�-�,,,.,�.-.�.�.�.:.,.�::, - - -- - - �:
Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT
AND
CERTIFICATE. -OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
— CLASS OF WORK —
New Alteration Addition Demolish Move
"O— ❑ ❑ ❑ ❑
Job Address
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Name
c
Mail Address
Occ. Gr.
Type Const.
Use Zone
3
0
Use of Building
Phone
Floor Area
Height
Name ?
No. Stories
Lot Area
Frontage
°
Address
Occ. load
Occ. Change from
0
f
r.
Plat File No.
No. D.U.
O
License No. =
3
Phone
xf
Garage area
Fin. Bsmt. area
Lot Block
Filing Number
Type heat
No. Fireplaces or stoves
a
N
_
Subdivision
— RELEASES — Dates
0
CE
.PUD
Zoning
J
Engineering
DESCRIPTION OF WORK
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
-
Valuation FEES
Plan Check
Stock Options
Plan No. Codes
Permit
Parkland
Est. Total Cost E
(including labor, material, profit)
City Sales Tax
St. Oversizing
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
+ 77- --
- - -signed
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
t 1 ((._t fi,1 /._da e �'-�_
Total Fees --
-
Distribution: Original - Applicanll'Blue - OfQe: Canary - Sales Tax: Pink - Applicant: Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
a
m
ro
(D
—�
<—�
'0
c
U)
c
N279 6
03 e 1 i A
Street Till `ic
:10t.
c
0
as
a
co
ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by _s , 1 j
date
2
Permit No.
Date
1 4 , ` ---)