HomeMy WebLinkAbout2818 Antelope Rd - Applications/Reroof - 09/24/2014From Affordable Roofing Inc 1.970.207.0289 Wed Sep 24 10:41:51 2014 MST Page 2 of 2
� - Planning, Davalol»nene &Trar"partation
M It Cdkgo Ave P.C. Box Sao
c 1L + i For, Cd5ns, CO 80SZ4
f � Phars 970-4U-2740 Fax 224-5 34
ovER-THE-coumrER PEMRTS ONLY
This apylloadon is to be.us¢d to apply for the following Permits only (chenkall that apply)- D Air Condironing
D-Derilnlitton (mia6ur non-K uchirey D EIertdcal Aiarellon (notamvlm charge) D Ges Ughter ❑ Gaa Ln9
D Hosing Unit D Lawn Sprinkiar ❑ h0obila Horne replacement )$RonMg O SMW Line d phaW4tdfWC
n Ventaation Q Waiar HOelliar D water Line D lNovcvP 11et Stave (Q=iYS EPA oerded. Provide make; rnodei and
marndsdurar).
Cam okmall eppfreable'"Or aationOnt`he-en1310"on Incomp30teap¢iiC6U*mivwnntboaampted.
Application " [ O U/ iV Date
RarO� raQ.onty
Job Sb) 4ddrimus jism errl ' Value Of Construdioe (Idror, rreberrats} prom
Property Qvmer Name Address cm!/sare Zip Phone
_ ✓ w i ee � ALA V-
ApPrncantName Addtis: Clty/StarE zlp phone q7a
pt a�a� tii aal ux 'i—e-di V�,o �i � CiS $OS�S 207 aaoG
Corrtrdttg Addre�s /state ZIP Phone
Cm"=r E Y of P[ CddNs Sales tics, Are you Payfip tam here or by rellom, arHOre 0 IieAorY VI
Srcraraumbab�P Wdd'ma0aomr>< Am you paying with your lnr9t-ao omi7 FlFes D No
SS.d65 a, escls tal Or COPtonvdill pr0)CQ3 Ifs Rrskl=M 0 Gmrr eidal
II naderdfal, ftit ld Sln¢e FwNiy Detached u Crmdo(Yr irmhorrta (single family etlattred) G Duplex
G Kilifamly CaoarinwO ❑ Garage
>; commerdai, 6 %- ❑ Rank ❑ Bar D Clwrxh r7 HatgVPWE! D Kedirai alas D orrlca. D Ralae
❑ Resaurent D oitm (a(wril
rs this bugdk!a SD yaa'ra of age or rrm e? '❑ Yes. U lto .x . .
yes !a?+met'r+eed m adrrEar�}/ASOtaie.Arsotgtmn
if'tttlsis fern da nolition peiiak whatyedr.was the bLflUn9.con�•a.�di-
A`prrorA� � ynri ocT!/nan7brr'a6Rraa esasr■vrt tb srBur9FMoBlr EhC4.eyrpDadJnr, .
D25CfIptSDn or Work T -o ; Tua-p t� dflt 1:5 04.
>rII iavin �rk:Kkt/harMtar p�avcrA�er, mrre295t ifoen�lplumber.II1hNtlrrm NC mutt 1t41dsn.9i:d e1eLMdm>_ ,� �
St�S#AntreelOraliSltlie[LTImtYa�/hMrt[Y GD'bff�CA16hSAY.?�c-
ge�idan qum�_f>stlran� Roonc R^ (8$Q qy,g
I hereby a7mowdedge that! Nava reed this apaUaatimr end mate that the above Gr0?rrRtjan is oomplat9 and canna& ; agnm m
amply me, aalequGeoteot4 mmistned heltk, and dy ordirarr ea and Sete -lays TeguW" teiading oclnetruC m I kneecthatO
p"t is netvauti ur" it has bear paid and 6sued.
Appttcsnt:
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