HomeMy WebLinkAbout931 Kimball Rd - Permits/Single Family New - 05/13/1983City of Fort Collins BUILDING ,INSPECTION DIVISION
♦oFuceTION FOR BUILDING PERMIT AND CERTIFICATEOFOCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 61- A Ec�PL
Name AtA
ffi
Mail Address
0
Ph/one
Name
V
License No. _rN,
Phone
a
Lot
Block
Filing Number
Subdivision..
PUD
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J
--
OF WORK
1DESCRIPTION
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a,.�`S t '� Ci i♦ S f
t • �n
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Stock Options
Plan No, Codes
Est. Total Cost
lincluding labor. material, profit)
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 regglating building construction.
sighed - y date
— CLASS OF WORK —
ew Alteration Addition Demolish Move
ry ❑ ❑ ❑ ❑
Qlbg,Mach. Elea Struct. Fire Prot.
TT . YY St 'Eli a ❑
�t
Occ. Gr. P,- 3j Type Const. V •
n
Use Zone K
Use of Building
�-.-,�T��
ea i 5C
Height
ries S•
Lot Area Cj IqOG
Frontage (f �'
ad
EPIat
Occ. Change from
No. 3 tit(
No. D.U.area
� V
Fin. Ssmt. area
Type heat :;. ,r •�• �.;
No. Fireplaces or at
RELEASES — Dates
Zoning `�'Ik 1)"6 i-!-S> 4`-'Jt"tJ"'J
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review&7C Ij /mil'-4 Z- ''-
Special Conditions:
Valuation FEES
Plan Check
Permit
iSs 3v�f,
Parkland
Z e O 6
_
City Sales Tax _
yy . SO
St. Oversizing
Z '00
_
Water Plant Investment
a_OD
Sewer Plant Investment
Storm Drainage
Electric/Underground
'.,��-Jf%\C1 • Crs�7(�,.�
Tetal Fees -
141
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
Cyr
Reversed Corner Lot ❑
M >
VV
(010)
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D
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cc
A
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n
�RNTS 5
7'42
Street
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ZBA Case #
Date
SBA Case #
Date
Building
Insp.
Approval
by
date
`}J�
PeA nit fi o. %
Date
t I+
OisY riOubOn. Ongmal
AppLcanf:'61ue - Of6ce: Canary - Salfs Tax.Pmp - Apphcant,Tag - Bldg. Insp.