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Home My WebLink About5102 Madison Creek Dr - Permits/Reroof - 10/24/2011FF,6Avr& rt ( City Oi Collins Community Development &, Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134 -fax Building Permit #: B1109439 Issued Full: 10/24/2011 Site Address: 5102 MADISON CREEK DR Job Valuation: $3,000.00 Category: Residential Owner: BELLUS, MICHAEL J/LINDSAY R 5102 MADISON CREEK DR FORT COLLINS, CO 80528 Permit Type Phone:970-631-2986 Residential Roofing Zoning: Front setback: Rear setback: Right setback: Left setback: Minor Amend #: Plat File #: ZBA Case #: Zoning district: LMN - LOW DENSITY MIXED -USE NEIGHBORHOOD DISTRICT Legal: Subdivision/PUD: Code: Res sq ft: Com sq ft: # of stories: Occ Group: Fire Sprklr: Stock plan #: Contractor: AFFORDABLE ROOFING & RMDL 217 W TRILBY RD FORT COLLINS, CO 80525 Subcontractor(s)___ Roofing: AFFORDABLE ROOFING & RMDL Filing #: Lot #: 30 Block #: Ind sq ft: Basement sq ft: Const Type: Stock plan options: License #: R-1859 Phone:970-207-0000 Phone 970-207-0000 Supervisor cert#: License Number R-18% Work Description: REMOVE EXISTING ROOFING MATERIALS AND -REROOF WITH 30 SQS OF 30 YR COMP SHINGLES. PROVIDE REQUIRED ATTIC VENTILATION. ** SCHEDULE INSPECTIONS *** By Phone: 221-6769 *** By Web: http://amos.fcgov.com/CitizenAccess ** Inspections: RF TOTAL FEES PAID AS OF 10/24/11: $108.25 Payment method: Trust Account Fee Detail Displayed on Next Page As a condition for the issuance of a permit, I hereby declare that I am the owner or owners 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. Carbon Monoxide Alarm required within 15 feet of each bedroom entrance. Signature: Print Name: Ko' yy/--la s e `, Date: A- 7-1/ - / / Form Revised Oct 2010 City of Community Development & Neighborhood Services Fort Collins 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134 -fax Building Permit #: B1109439 Issued Full: 10/24/2011 Permit Type: Residential Roofing Site Address: 5102 MADISON CREEK DR Job Valuation: $3,000.00 Category: Residential Transactions Method Check Number Date Paid Amount Paid Comments Trust Account 10/24/2011 $108.25 Receipt issued: 10/24/2011 Total Paid to Date: $108.25 Fee Description Account Code Fee Amount Amount Paid Date Paii Building Permit Fee Without 1000.422010 $38.50 $38.50 10/24/2011 Subs City Sales/Use Tax 251.122030 $57.75 $57.75 10/24/2011 County Sales/Use Tax 100.217030 $12.00 $12.00 10/24/2011 W.... $0.00 $0.00 TOTAL FEES: $108.25 $108.25 $0.00 TOTAL.BALANCE DUE AS OF 10/2412011: 0.00 Fee Amounts are valid for date of this document only. Fees subject to change without notice.