HomeMy WebLinkAbout1624 Silvergate Rd - Permits - 05/28/1992DEVELOPMENT SERVICES/BUDDING PERMITS & INSPECTIONS DIVISION
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
itv of Collins,BUILDING PERMIT
JOB SITE ADDRESS L _
H Permit Type Nbrk Type Category Type
wa Proposed Use Use Zone Permit Level
- Subdivision ❑m PUD ❑ ; Filing
PERMIT FEES
Q
SubdivisimLFUD
J
Lot
Block
Parcel No.
Last
First
M.I.
Z
Address
City _
O
State
Zip
Phone No.
Company Name
Contractor License No.
Q
Address
City
ZO
Zip
Phone
Sales Tax
U
Occupant Load
LL No. of Dwelling Units No. of Bedrooms
O
Z
O Text:
U
to -
ZBA Case No. _ f I BBA Case No.
Permit No. 1r Permit Date
State
Separation
4 �
As a conditionp/�r a issuance of a permit, I hereby declare that I am an owner
or the owner'stagent, authorized to perform the proposed work on the property
described her n. I agree to comply with all the requirements contained herein,
and City ordin nces, and State laws associated with such work. I understand that
such permit ray 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.
m
Building
FEE DATE PAID
G�i 3a
LEFT
SITE SETBACKS
REAR
RIGHT
FRONT
CALL 221-6769
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
TOTAL FEES tyi,=L.2 5
Fire Containment - - -
Stock Plan Options -
DEPARTMENT
STATUS
DATE
SUB
CONTRACTORS
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- -
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Electrical
Mechanical
Plumbing