HomeMy WebLinkAbout4615 Dusty Sage Dr - Applications/Single Family New - 04/11/2005r_
City of Fort Collins
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R Mailing Address
Phone
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BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
First
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LN. DR. CR. WY PL. ST. CT RD. AVE.
Building Square Footage �—t 0
G)_ Number of Dwelling Units
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Q Stock Plan Numb r/Options
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n Date
Middle
State
Supervisor & Ce
LN.AR) CR. WY. PL. ST CT. RD. AVE.
Block Lot Area
Z22 2006 7-
Zip Code
Number of Stories I Building Heighl- /
Number of7.B�elog/Bathrooms Unf(i-nQlsh� ih' d Basement Sq. Ft.
f73 N
Water Tap Size / Sewer Tap Size N
Type eat: Electri ain Breaker Size (Residential Only)
Gas ❑ Electric 150 amp or less ❑ 200 amp ❑ other
i (including labor, material, profit) $ Z
Description of Work:
ectric Pedestal Requested:
❑ No
I hereby acknowledge that I hay2fread this plicati d state that the above information is correct and agree to comply with all
requirements contained herein nd ci In laws regulating building construction.
A
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Print Name ' Phone Z ZZ 3 7� Z
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE