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HomeMy WebLinkAbout1700 Lakeshore Dr - Applications/Reroof - 07/27/2011FROM :kess.ler FAX NO. : JuL 27 2011 08:10AM P1 Fort Crollins Pl ds& Darelopieat Tra P.o n 2M N. OoUege Ave P.O. Boot SW Fart CArS, CD 8=4 Phone 9 0-416-2740 ft 22+fdN OVER-THE-COUNTER PERMff$ ONLY This appBaWon is to be used ft mpof► for" faftift pe<ee0 &* (ehsek M OW "ply). 0 Air Ccetd(ffiutorig 0 Denx*man (inter non-M ruftnQ G Bectdcal Abaratlon. (not servks duurgs) U ties i.i*W 0 Gas Log O Heating Unit Lawn Sprirddsr Cl Miobiis Home repla© rent XRooiirg p Sewer Line Q Phob mft it; O Van O Water Header O Water Lets O Woodfthet ftm Oru d be EPA erer W4 pmvide nak%L modal and mmwdackrer)• cwomsta an goo&imle kd6fe an On Edon. AppbdWon #110 ��► �- I-eoON I I 8000oftes vM not be mcalftt . DaW • rvr vri�rse �r err 4 � �., 3" Slot! Addrt9f3 fro*~ - vmm of ( wwj nlatsriats, I70tJ k ore P. -- $ 3300 330 Property OwMer Na�nre -Address 2lp Ptane Mack r•,,o 1d 4orF Fm SOS 5 22-OcoS AMUCwtName Address t7gt/bTaee zo Phone Cnrttracw Lk #i AW Address CRY/St-ft Dp. Phone dty of FL CoWns Sales Tax Ne You Pov" tmee5 here or by.report? D Here �Rw:port ^.Ismrmwa &Awp ~lwaorfaor,�anaors Are ym paft vWM "w bust awmae XYes O No M LS d* a resMeWi or MIN. nCiesl Pr+ojed? 0 GDrronetdal ff io � G� r�rrtny o eon�el +home (single farmer ailached) Cl Dqft 0 MulB m* (aparbnwt) Cl Garage if cmnffo ial, is ft O Bards O Bar f] Ouch 0 moW/MoW 13 ftkw ffm O cake- D p4w D wswurant O cow(em*m) Is this bdkl '1g 1% searsof age or more? O Yes ,P�No lfja� _yan yneeed v a afi binecR n�eton If this isfbra demolition pen d what yw was the bteBding consbudon. jyp* rm 1974 pw ee vneedw astesw m gm 0►,t0 srwiett*0 4ofma nr. Desc iption of work _T -a r - 6f f ex ; WAD 1.1 e-&%je F . fa-1c.• i,. Astalu 2 ' o-A' r *ff lawn spriNder/pacldyoMr prevot v, must p5t Roertsed pkwtw. IF f lisz *n A/C, m= Nst icerwed dedrichm 9uboorrtra��orsc LBtd�e a�orn�arynsaoe ar�yafRclow,rc is mg Phunber - - - -- - Roolrer 1Z om. I hereby ad oftlge that I how read ft AVBcadon and sbie that the above ifoma m om Is mmplft and correct. I agree m - cmq* wBh as r9qWWneft'aordained herein mW dty arffl artoes and sbft mws 19 0 9 btd ft construdl uL I tmo -- Meet a p - a d is rm vaUd wlte it has been paid and bmo& a0pk=b pdm lure