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Home My WebLink About1718 Mathews St - Applications/Reroof - 05/17/20124 y .0 Penh% s Cdft 281 X CoNgge Avg P.O. Box Fort Comte, CO 80524 Phone 970.416.2740 Fax 22q-5;i3¢ 01 7'N M PERM ONLY This apt is to be used to apply for the fWkw tg pwmM onbr Iabadc a• lhae q AU 13 Aa'nolJtlwt 0n%ft nm- ucbz4 Cl Ele¢t mW AMm dm (trot ) D Gm JU Log Hoeft lhdt 'E3 LMm Sp*dder 0 Mobgs HomarMkoentertt R�0 0 Sewer late E3 Kdw ❑ Ventil m O Wets Hedw ❑ Wow Une Cl Woody SWm (must be EPA odd, pn>yr marurrge�,rrer). , MaW Cook" all qm hdo mmoon on the spot ort. lttoonlpl� Itpdions wlp trot be Ammon # bI a(o olqIOL4 'Date ak ValuaotCoedntCtiOe , I j .Pam 570o Proparty ONmer Na�'j Address Qty/tbe ap Phone bh ��ov�� ►AppEawl Mum � q3 Adder-atrisift ZIP I Imm Conaador Addre� tie 3� ,�r��aF F#�adom�s Tic � arse ra, aar�n� tames here ar trr ��a �pDrt `f`7►7_�<L �almr�awcrwx Are Y� R vdth your tntst e000� � Yes O'1Vo Is this a rvddfw" a e =mfd d P r. R O If mdduft, Is �, t a home (�in& tamer attadield) o 13�( . Is mmmudW, Is It � © avich, O HOW/MOW G Mew dF4e o Wml3 Re Is this butler 6o ym d }f'thisk for o dsmp�loe � ar more? Yea ONO �'ye� jaum�eYreaediv cs�ntdrtl'df'eagfcP Ir U* r f t9 MhAyear Mites the bufg cordbrtdBo 1$yorewiva dana slp!.amemottomen* wob* Desdi�iOttof •a . *If lawn ap wh rffiomow PwarEwr, mast Ilst ppio�ber, t<8tst4lme NGI rtwst tmt toessed f1 80600nbl4mst Wow aw aoynawararydrR 6f 'N C of wunnber j I hereby adatowledge t* I hens Rod this appkaom aM slaps that the above tin k eOrnptebe aid cdrredweq* WO I agree >b P� M aoafl wpdNqWWff& QMWleaItmeb afddLy W&OWO wd stem tiers mwobw bdddln®aonetruaf�t. t ts�wt a psld aed lamed.• 291 N. Fort CbMweege Ave P.O. Box Phone 970-416•2740 Fox 23 This applieatlon is to be used to M* for tiro following Wm t6 ohty (ahsok all that appby Q Air CI Damon (►trterior nometruaWmQ 13 Ebdricsi Aboradon (not wigs dwW) 0 Gas LJghLer IO G 0 Haa ft Unit 0 Lawn $pfnider O MoM Home: rapkworent ErRoaft C3Sewer Line Of o O Vardilai m 0 Water Hades 0 Water Line © WoodlP" Stove(must be EPA =ti 0, pn a mo manufaour". Complete ail awwoabio Ir h m om an the spout. lnaomakfe ao cations wm not he Appl)mWn # 810 ZO cDaWa- A rauft we only Log mode! and 39b Sft Address ( WOW Value of CourbvWon (1; , S T�j Co Ownr Namf Address Oty/State ap mm 70 o q 3• ,y �! Appkcant Name Address C ILY/SuOe ZIP i phorm conblebor Adder CRY/Sbft ap ' ph= 3o3 mi-Sa a: Gordraebor CRY .nf Pt• CdDW Tax # Are you PBYirig taoaes here ar by report? C1 Rgport bYa/ca s Are yrm payFutg with yow trust aaoount? Q Y Pa'lifo lsvftar-corapmemWpVaW l RoMential i] Caranerdal If redda id4 is Itr ftuy Ddached ©fond m (drgle femur attached) E3 If mmmerd4 Is it: o � Bw orwWriv 13 � 0 MeckW mVm 17 oftlm C W* o Rafturot a dh�r ( +) Is this &Ait So � of age or mwe? 1Yas O No a'J%Yes=ynead M tOjAffiAxkAtrwmvpW c V !iris Is for a demo Mm F W% what ym was the try cwahcmd? ffpfwit "75 yuuwMngedanaa+ m �r9Eht sepp�limebur I hereby admowledw that I have read thtr apppca m and slabs itwt the abave Wbrrn is =Vkta and to horse cam* with a® � e herald and%etr &O wdm and stoe laws fi i a xmbu x "m perudt b ns! wad R bee been petd and IaNrad.