HomeMy WebLinkAbout1917 S Shields St - Permits - 03/08/1996 (4)Community Planning & Environmental Services
BUILDING PERMIT
Building Permits & Inspections Division
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522r0580
221 6769
JOB SITE ADDRESS 1917 S SHIELDS ST
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BLDG PERMIT NON S 74.50 960308 `°'"°°
c CITY SALES USE TA 128.10 960308 Plat File No.
SORT COLLINS COUNTY; SALES TAX 10,73 960308
Phone N$84-
Off St Perking
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INSPECTI
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cicityFT COLLINS StatCO REQUIRED
• B CALL 221-6769 •
TO SCHEDULE INSPECTIONS
482-9100 Sales Tq 8187 (See reverse side for Inspection Description)
TOTAI. FEES 1 213.93 I 1 I RF
Area
Options
0960641k)t' ' It- RPCH 8, 1996
As a condition for the issuance of a permit, I hereby declare that I am an owner or the
owner's agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and City ordinances, and State
laws associated with such work. I understand that such permit may 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.
Date
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