HomeMy WebLinkAbout706 Morsman Dr - Applications/Reroof - 06/18/2012Jun 181201:14p
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This application is to be
❑ Demolition (interior non
❑ Heating Unit ❑ Lawn
❑ Ventilation ❑ Water Hi
manufacturer).
Complete all applicable
Application #�c
ns
THE -COUNTS
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Port Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
PERMITS ONLY
to apply for the following permits only (check all that apply). ❑ Air Conditioning
tural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
ler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
only
on the application. Incomplete applications will not be accepted.
Date
Job Site Address (requir
) Value of Construction (tabor, materials, profit)
acuf.').00
Property Owner Name
Address j City/State Zip
Phone 3,0 3
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-76 f ` czT law. C FTC C6 ' S
-7 fa - /9 Oro
Applicant Name
Address City/State Zip
Phone 47a
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Contractor
Address Gty/State Zip
Phone
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I
Contractor City of Ft. Colli
s Sales Tax # Are you paying taxes here or by report?
❑ Here ❑ Report
5alestax number isregz e�by
lmatraCtom Are you paying with your trust account?
i
❑ Yes ❑ No
Is this a residential or cdmi ieTdal project? IM Residential ❑ Commercial
If residential, is it: M'Sii gle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ HL Itifamily (apartment) ❑ Garage
If commercial, is it: ❑'Bak ❑ Bar ❑ Church ❑ Hotel/Motel; ❑ Medical office ❑ Office ❑ Retail
❑ Re aurant ❑ Other (explain)
Is this building 50 years o age or more? ❑ Yes ❑ No If yes, you may need to contact HistoricPresemahivn
If this is for a demolitionFanasbestus
mit, what year was the building constructed?
If prior to 1975, you will n assessment to submit with this app/IralYon.
Description of work
al S vane
e v v o e ayc:O r e• a CCU ; S �-=r-C i
Oa ricQ mid Si."e
*If lawn sprinkler/backflow I
Subcontractors: LIstthec
Electrician
reventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
panyname orOtyofAit Collins hcense,,rr
Plumber Mechanical I Roofer Other
I hereby adinowledge that I have read this application and state thatIihe above information is complete and correct. I agree to
comply with all requireme contained herein and city ordinances aid state laws regulating building construction. I know that a
permit is not valid until " has been paid and issued. I
Applicant: r /
Print Name: 'p"',o s.l 1til..t1 i tl 7'I ' 11 Signature---12 `�� �—i� Date