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HomeMy WebLinkAbout1707 Dora St - Applications/Reroof - 09/28/201110/03/2011 09:54 9702669123 DRENNEN CUSTOM CONT PAGE 91/01 0( r-or�t Coltins Plennit Dwdopbtm t & 281 N. Coliege'Ave. P.O. Box 560 Fort Cofihvl CD 8=4 Ph" 970-416-2740 Fax 2245124 OVER -'SHE -COUNTER PERMITS ONLY TWa efpplioatian ls_to be used to apply for ft fallowing permits fly► (dwkall dret apply). Q AU C %fifioning D De"Non ('mom non- ftMral) D ®ecftW Alteration,(not a ce change) � Gas Lighter l7 Gas Log p Heating Unit p Lawn Spdntder. D Moble Home replacement g D Sewer Line to Photo- dtaic 0 Verl iktw .D Watar beater l7 Water Line. D Wood/Pellet Stowe (must be EPA carted, provide make, model wd manulactarer). • Complete all applkable Uriormatlon on Me OPPl UMOn* inaon vide applk4tion6 will not be sifted. f 5,/%.. Application o . � � r-9 lob SiEe Addeesa ( Value of Con�rucUna O nbor, mammal per) address CTnr/swe aP ' Property Owner Nam� '`Phone 17i7 Dim AppIcat t Name Address CitYlStaba Zip Phone Contractor Address ' CRy/�ate Zip . phone Contractor City of Ft GoUins Sates Tax # Are' You paying tares here Or by report? Here D Report Saks rAdlla k rr r d bYaV Are you tang with your trust aura? )Yes D No �Is t#rls g residential or cmnrrrexdal D> O Cn� If reSdentlai, is t Ongle Pamly► Deter D OxWq/mwnhome (single fw* au3med) Cl Dupkx -13 MLMmlly (epartlrtent) D Garage If=nmerdgi, isit D Bank 13'ear a Church D Hotel(Mlotd 17 Ke.dcal office D vtiiae D �'t ©r>t o other (egin) IS the Wwmg 5o yws of age or n wre? = Yes ' O No AF1 .1 m ap nod m a>irl�a H A ,ra n If this is for a de wdWon pw- i-= what year was the bAng QorwMxftV lfpmr a,10% Yw WHIftad an soeswwaomwww son* &A* d*4whimain 1 hereby admwAedge that J hears, read ttiis a VNestion and state lust the abmare hftn adw, is aomplete end erect. l egree to comply vath all requirwr&I s corrmbred heReih and dq ordneaum and state parrs regulating bWdiag corabuctim. Z know theta perrrtg is notxalid Wti31'd be6 been pall and issued. APp . ��> onto Naaw~ r �_ --