HomeMy WebLinkAbout1933 Mesaview Ln - Applications/Reroof - 10/04/2011OCT-05-2011 11:25 LARIMER COUNTY PLANNING 7711 P.001/001
'' UCi• 4. LUI I o LtlNM AUVrIVUtU KUUrIINU No -Planning, Development &TraLFW&ab.:on�
� Q� ����.! C15 z>31 N. coilese .aye P.O. acx seo
Fort Collins, Co 80524
' Phone 970-415-2740 Fax 12¢6134
OVER-THE-COUNTER PERMITS ONLY
This apgUcaticn is to 5e used to apply for the ioilowing per,nis only (check all that acoly). Z Air Conditicrir:g
❑ Demolition (here: ice noMsr cturxl) c!ec:fit 21 Thera 11 (not service chance) G Gas Uchtar Gas Log
0 Hes ing Unit ,T Lawn Spi'mWer G Mobiis Hor„a replacernenAL ! '' :Roofing =, ScWer line Z PhoTo-uolteic
0 Ventilation We!=—r aster ❑ Water Un0 Stove (must be EPA car;iiied, provide make; modC and
rnar iufa=.rcr).
Compfete all acclicab Inicrr:aticn or, the appflcvt cr,. IncoMoiete arplicsticns Will net be accepted.
Apoii torl = I o bs &3 uCtc /oz—�---L l 01'99
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r �.SiK A"J ess (re7✓ir`d) i/3«e c f., sw rci�cn ;,.. or, r__..__, pr ;
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Applicant Name Address `up P".0ne ?O
tD"rNcen �0o�tRg 1�-htoW-5 4io* 6er4S De Wlnctu,r Co (063-0,Q0,:
Contractor Ue AddressZip Phone
Saco C`,. Cns !2-��1�1 g
Contractor Cif/ of Ft CGllirs Sales i ex Are you ;tying taxes here or Sy mpert? 0 Hem 0 Keporc
S6/e9wr41Wrde1iS-fa are. PY&IOnrrcbrs Am you paying with your pus; account? l.Yes 0 No
o"�c1DSCfl
Is this a residential or Canme=21 aroma? J Rsicen zl ❑ Cornnertai
TY resseent ai, is it *Ingle =amAy Demcled ❑ Condb/townhonlc (srn;le family attaclee) ❑ Duplex
6:l Muldfamlly (apart-nert) u Garage
u co m- erdal, is it: 0 Bank Szr ❑ Chum Cf -ctYof;;Ce 17 cr C ;L-Zail
0 .^ant ❑ Ozer (eX Ip tin)
Is this builCng Sa years of age Cr mere? G yes No ifP!, ycu r,_yge a C;r:FC2- rLC-LGrc R. agcr2ccn
If t :is is fer a demolition permit, whet year was tl;e building c:nst.^.xze0
Ff pr.'Cr to 1975, ycv w11/'need an as5s-< zTae� teY t s✓cnr wig this aFo11`cztic
of
*if Icwi,;;,Nnk*-/bate--cw rt�rk il. gczn r=d 'ilium-i e% _i rirr-trnf AjC, nlue, hush. licensed
Scrca r.. zr+ors:1-:T, Oe c rl any mire ar C tl of P! C^Ill'-s Ocsnse
.iec i6Ln Plum.;.^._r R:cfer A=&,c Coe,
I hereby 2tf4,cwl�ce t at i b=ve reed c"is z ciic2Lcn and rZta ;ha: the a:cve ir),for�atlor, !s :ompletc and. arr3�. i agree iv
,GRIFiy w1b all re-uirt„e�S cti iizzinQ� he.-ein and Uhl erdirar!:ea er1L+ :ate IaA'D iAg-:12tnq :uileing :7rs�tL!. iG'. F know that a
permit is net valid until It has been paid and ss:jed.
App,-Icant: i
Print Name: n cL Signa',� Oet. ��