HomeMy WebLinkAbout2042 Bronson St - Applications/Reroof - 09/28/2011Planning, Development & Trarsportation
81NO�O
2g1 N. Coi(ece Ave v.0. 3cx 580
ti ins -or: Collins, Co 80524
P"one 970-416-2740 r x
OVER-TH-E-COUNTER PERMITS ONLY
This appiication is to be used to appiy for the foilowing perf.zits only;ci;eck all that appiy;. Air Ccndi;ior„rc
,:-! D6r,Gli:i01 tIr'i6rlOr rlCr'.-5.f LIC._ c!) ❑ Alteration &8^!(C8 iJ 02ss _9CJ'1 �tar ...: v^2o--.+g
"feed; g Unit 0 Lawn -Sorinkles = Mobile forma 7epiacernent _ Rocf-ing 0 Sews( Liit3 � �iiCiC-Vv^ICGIC
Oj Ventilwfon!_-- Water.Hisater ', ter Un8 W-^Cd:�eilei StoVe (rnUSFPA cert:fied. Yrovide rn2ke•; m-odei b.1 d
Manufacturer).
Complete all apelicac!a information on he a:.pllcaticn. Irlcocripiete appiicaticns wlil' not be accepted.
Appiiation F2 -c7t� c� I
r -r cif - use orrly
1
auk S! a Ariiiraec 'ia+r�ry_j� � �/Siii2 ' isC?i;+s'<!'.i��?�"�j�.sstarW � prri:y
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Property Owner Nat ie nyvi e$z
city/State
Tic
P"one �7D
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Applicant Name Add, ess
C'^/lS�.e
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Phone �70
1f;DV'N.C9Z A;c%'pk
S. r•?-s 4�2 1 r
r- Co S'0550 (�63-620
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/jam
P%honC
Conta�xr City of FL Coilins Saies 7 zx Y
Are y=� ;.;?yi!-g Lx�s
F,er=. or �y r$rCf=
ire-e !� ncport
ales eaxawnba-1 !!*JI/-=d J), 0 %ti:CJ
�.'.e y-cu paying. with your trUst:'acrjurt ?
4s J NO
a 4osto
fr Is ;;n s a easidef-Llcal or c6rnimercial rrc,e ? Kesice; l�ai El ....M-' e; _ -
T! r��ident�i
2!; !s it; ryie rcr'tilV DetachedCondb, _ewrlione (s,n5 e 2...� .�y ache..) Ew Du_:,l_x
11
- u. MuIL1a,�l!'ry (aparment) 0 Garage
:f cornimerclaf, is it' _C) Bank 11 Bar GG Church a : fcte!JMo=wi, J-Medi`i office i !' OMce, O R :311
0 ?es�!3r2nt Lt ("-ther (evil ir.)
IS 1iis 5!:i!dirc,•' 50 years of age Cr mcre? 0 vez- do L'yes, } �U may nsec"_'O C::/?L7 rSJnC /�i452r`2I`iGl
(I° tis. is �cr a demclifioh per-mit, What year 1h2s the fit: idir,C C;�rSt~'JcBd?
.1f ,br ro 1975, you w111 nod en _sbe. s assess„gent tg sUc%ir Wit')
of
Ij !cWrl sprir.!der/b!scctew NB`�$rii$C,'T::sv i� lic-3rsed plumber. 111 A/C, ri1!S-l:ls` !icarS—. ele': 'ic7ann. '
S&jbcontr actors: / if the C7Tf.Eny;-.a",i,z Jr i.iel Cf r: COAM.5 kaj se r
i?!ecrcar. ?!irrrcer !�!t ricat o�f3r C�he!
Q w 2C:G:.CN/iE� 2 i:.lc� 1 i18V� rE2Ci :i^i5'�r �IIL$:iC'n ERC�. S�a:� `�?cam tle 8.>CVe, ira ;.� .r.� a ra -^ cC "at I t
�! rs y 9 p� �.rt?iE:!�7 i7 ri':pi�te �. 1 f. ��.. I zgree �
cCriiNiy'wiih all re-uli erne-u t:?%L ned hereir, an , rr ^•di ce E.n s I c,0 t -r 6 i ^� wn5 'Lc"! Y n ��'
i c c' 1..!r.: �:_�s _ e si to a!as rc_. ,zvll_J J01.0inc � cn. -know at a
permit is not valid unt;l It has been paid and issued.
A`
?pliza .:
Print Na,,�e: l� i1 CSC �1 5is. Iz_ t , �Q Jata'`
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