HomeMy WebLinkAbout4501 Boardwalk Dr - Applications/Reroof - 08/06/2014FROM :kessler FAX NO.
Aug.06 2014 07:42AM P1
Gr�t`�olllns
Planning, Development 8t Transportation
281 N. College Ave P.O. Box SW
Fort Collins, 00 80524
Phone 970-416-2740 FIX 2246134
OVER-THE-COUNTER PERMITS ONLY
This appti eSm le to be used to apply Tor the tollewbW penults only (*hook all that apply). CI Air Conditioning
C Damobtion (Interior nw stnaotural) 0 Eleatrioai Alteration (not servlbe change) 0 Gas Lighter 0 Gas Log
O Heating Unit 0 Lawn Sprinkler ❑ Mobile Home repot jKftmtg O Sewer Line 0 phob vofb lc
0 Vendation 0 Water Hewer 0 Water tine 0 Wood►Pellet Stave (must be EPA oeffW, pr Mde make, model and
manulboturar).
Compism all applicable Information on the apptkretlon. In*omplets appBoagpna will not be a*osptod.
Application # b4o 5;3q 7 Date For afte Lw a*
lob Ste Adarese lid)
value of CU"b union (labor, materiak, MM
4601 Boa rcl wry le d r
wag e! P 3 S'ao - a" 5 s qb Is,
Properly Owner Nam Address
city/State Zip 479?Phone
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F wdev Dorn gropwgr �d 8a0t0 ° .-29g1
ApOcant Name Address
atylSt06e Zip Phone
Contractor , Addnw
�esoi� S" ,r t .(per
aY/ate Zip CM-) Phase
$ 1 �i �? "14 C r. F�''�
Conb dw City of FL Collins Was Tax # 704P47JO
wares tear ffA7*w tr requies *a9 aanhwW& Are you paying rth your lure? aocount7 )<Yes 0 No
Is this a resklm%al or eommerdal pmjeW firftesickintlal 0 Cwwewdai —
V reWdenUd, Is It: X.Slnoe Fw* DetadW 0 Qnftftwftm (sbrgk, far* attade* a Duplwc
O Muftnn* (aparbnent) 0 Gus"
If eommer+dai, Is It 0 Bank 0 Bar 0 Church 0 HOWMOW 0 M"W ofilee 0 Ofdee 0 Ratan
0 Restffurm t 0 Other (eciftln)
Is this bullft SO years of age or more? 0 Yes h*yp.;. ytut tfWnwdto r HIsft* PJw&vwm
If this Is for a demoliti n permit, what year was the budding eoratructsd?
FP* r tb IM yaa wT naed avr aWOORMW 90 X,67 t MW tAtb rtopO�Grn
r
*If lawn gwktMw/bKkow praverw, must flat licensed pkwd)er. If first tlme A/C. must VA Imnsed dec Aden. u
Suh*oaI I rarLAitftwnpwynmeorCIlyefFtaAmAbmoif
I hWeby adoro Nledge that I have read this aWMcetion and state that the shwa kftmnom is wmpkft and w"em I agree to
con" with It b na all
m*d has been paid and Nnrad. and state Iowa rep uldhV buI ft un brudlon. I know that a
PWntt l'o- w: # Applicant
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