HomeMy WebLinkAbout5151 Southern Cross Ln - Permits - 06/28/2004Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 5151 SOUTHERN CROSS LN
PERMIT TYPE PERMIT
BSMNT Basement Finish -Residential
Last Name, First, Middle Initial
DOLLAR, MARK
LU
Address City/State
5151 SOUTHERN CROSS LN FORT COLLINS, CO
O Zip 80528 Phone No. 303-564-4252
Front Setback ao�r Cafher4
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Right Side Setback Left Side Setback
Z
NPlat
File No.
ZBA Case Number Zoning Di:
J
Subdivision/PUD
Filing
Q
wLot
Block Lot Area
Parcel No.
J
O
Company Name
Contractor License No.
RAddress
G
City/State
Phone
License No.
BUILDING PERMIT
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Building Valuation
80402960
ACCOUNT
PERMIT DATE
06/28/2004 Plan Check Fee
EVEL CATEGORY TYP
ISSU_FUL Residential Remodel Building Permit u/ Subs
Construction Type I Occupancy Group
Q'
Mechanical
License No.
0
Roofing
License No.
H
Z
Framing
License No.
V
Plumbing
License No.
N
Concrete
License No.
w No. of Stories
OBuilding Square Footage
Height
Stock Plan/Options
(See reverse side for Inspection Description)
RP
RM
CL
IN
FNB
FNE
FNP
FNM
SPI
UCP
FR
FP
RE
BASEMENT FINISH TO INCLUDE LMNG AREA, BEDROOM, BATHROOM, EXERCISE ROOM
57,1 HOMEOWNER TEST AND AFFIDAVIT ON FILE
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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 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 or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced, suspended, abandoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
/111
Print name of owner/agent Signature Date
City Sales/Use Tax
County Sales/Use Tax
TOTAL FEES
$20,790.00
FEE DATE PAID
$15.0 5/13/04
$197.7 6/28/04
$311.8 6/28/04
$83.1 6/28/04
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