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HomeMy WebLinkAbout2950 Neil Dr - Applications/Reroof - 06/06/2012•06/06/2012 03:31 FAX IR003/004 Ci-i Colifns Planning, DevelopnWM & TMnolmirbalon 281 N. Cdllege Ave P.O. liar 580 Fort Collins, CO 80524 Phone 970-41&2740 Fax 2Z4.6134 OVER THE -COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (chook all that apply). 0 Air Conditioning ❑ Demolition (interior non-structural) ❑ ©ecbical A,iteration (not men** change) is C3aa tighter ❑ ©as Log ❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Horns nsplacem int �[RcaRng ❑ Sewer Line L1 Phodo.valteic El Ventilation ❑ Water Heater 0 Water line ❑ Wood/ 9flet al(rnuat be EPA carNed, provide make, model and manufacturer). Complete ail applicable krrformati n on the application. hwomplem apgtie moons will not be accepted. Appilca#IOn # b I Lo�Date f;ardflAwLMa* >A++ etas Addrh9sa fi I . value of Conaltuction (labor, mrt Wr, pro o ....295v Nis Dot [tr���s-s� s Property Name Address Cty/state 21p Phone (Owner i + 1'ry v� na tMt 300 F U'Aw4k. 4, (014, (0 r6rd)! Applicant Name Address Gty/Stabs 21p Phone r ` FiChI. Contractor Uc # Address city/ta�e Z#p PT �Oit(,rd Phone E J 9 Contractor Gty Ft Collins Sales Tax # Are you paying taxes here or by report: 00re Ci Report sabs awnL" Apra,byallowtvdalm Are you paying with,�otrr bust account? 0 Yes IXNo is this a resideMal or cornmerctal project? IXPJMdWW C] Commercial if realdendal, is it: D Single Family Detached XCondOtownhorne (single family btlached) O Duplex 0 MulwWray (apartment) Cl C4rage If commArual, in it D Bank l] 8ar O Church 0 hkrG"d ei 0 Medkal of ka D Onkm O Rehr D Restaurent O Other (expla_ �It) Is this bu ding t30 yearn of age or more? 0 Yes No ayt gnu mry geed m mn�ctM�vht: Preaen�Dran If this is for a dernolltlen parm t what year was the bu§MV cons Udje d7 D°pnur tv 1973, you wdl/ nea+d an a ',bibs awavwjwt to WO drlr app&vbb a of work # x.- c ,' 3'j 300-^s *If lawn Wrikler/baddlow preventer, must.lhet Ilcenmed plumber. If ilrk-tlnte AIc, must list kwhaed electrldan. tilu600niahaedo— Lame wfr nam® ororyarRCLulbhis Aag e 0 Plyhntw Me&W*W RWW _ Other I hereby ad= wladge dint I have read this application and state that the abet tnfarn ation Is eompka and aorreeL I agree to comply with all mcgrxne-ts coMalned hwelp and city ordnwwo and sbft taws reg"ng bum cOnSbuCtlam I know that a p ulft is chat bland uno it has been paid and feared. Print Kr : Ovu.t,. toyu.� t>,liiinsia+e Data