HomeMy WebLinkAbout4924 Smallwood Ct - Applications/Furnace - 07/06/2015JUL-01-2015 11:001"M FROM -
T-012 P-001/001 F-019
Planning, [)eveltipulont Oc Transpor'tatic) n
2£11 •N.. C011e9ti Ave P.O, Box 580
1=oil' Collins, CO 80524
Phone 970-41&27 10 F"lx 22+1-f;•I'an
QvEk-THE-COUNTER PERMITS'. ON LY
This application. is to be rlsecl to -apply for the following pormil only (chock all that apply}, l l Air C.,'onclilionirxl
fJ•Drmoliti0n (iRtelinr non-stiucfur�l) 0 1=1ec Ific&l Atfr:ralion (nett selvico crlancjo) fl, Glt; Lighter I-1 C3:;1`:; t_oci
❑ I le�finrl lJnit C7 l,lawrl :Sl:,rirdder I:J Mobile I-lon'le PePl81cernenf • b Roofing Q C)cwor 1-Ine 0 Phofo-voltak,
(:] Ventiletion 0 Wilter Neuter 0 Me ter. Line Ll VVoocvpcllet Stovo ( I St be manuf00turer). t;P'A cerliticl l,. Provido rt)uko, re,oclel '-'.Ind
Comnleto all aliplicabIq information on tlit± applict,tiorL 111"Illplete al>Ulic It o
Application •1!___ _PD1SC
_-
Aar olr)ce 4�C' or)ry
J(i Site Bukjress
1 n� will not bo ilccoptod:
UaEe! __ ENTERED JUL 0 6 2015 _
Villuo Of Cb11Sl('U lion 0at,or', m erials, profit)
3 YH,R ' GI�Iyty/J LCII ,Zip
Applicant IVanYc ,Addi ess
)rClt/ Y/• Pale �I:Y P1lorle
r
Contractoy
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CorlUartor Cily. UP I't; .t:ollins Sales - - ~_-- ^_._ • / �(I':_-- CJ ,J cS...� ��L
fi:lx //•. Are yoll })crying taxes heir, or by report? LJ I'Ic;rr.. (.:I RepOrl'„
'tYr(sG>k)NnpGerrs�grrr,•�+CrOW/coolvBCem, Are you paying with youl'tnrst gcr,Gilnt? to 1'c'S I=1 (lo
- �-
Is l:hi5 a r(♦sidQrltial cr tntercial project-, ; I�esidential LJ Ca~IY�rtte rCial�^�------
II'residentliil, is it:. Singh 1=2�mily IJet� hed D Condo/townhome (single L ; Multifl�nnlily alftad'led) L=} Uu �Iex
timily (apartment) E] Gararde . I
Tf conunercial, i it: EJ f3arrlc L1 0ai EJ Churcll 1_I Hotel/mote) office [7'OF(ice I-1 lZefctil
Q RestFltrrant: Q Other (explailt)
Ir this buildinq.a0•yraarc); of zlge Or more?, E"7 Yos 1� No 'IF yO — it this is For 8 ,cloliiOliitoai Pnrnllt, what• yca'r was the blrilrglld pesCOlt loll II)IP IMCiy (r, ew�lrrch gip;"�,ic �;�`.,' , `
1Pprior (n 1.9%,�J jtr lq,i// rleed ap EjsGes(ns ass ^ssgYenh (o sc)Gir�it 1pil/1(/jis r'ipp/ii r)(ion, ---- _ -•_ see v l(rOn
QL-'SCI'iption of Wg1'1<
if fawn spririkl(r/bail<flow pr—�eventa., "lust, list license pjOmlYer, if first-umr A/C, Inlhl' list liCtl'15 -Yy-- ^- d rkrUl(.1116 —
6illiconl'r rGtot'S: (ia(•tlic �v)n)/x7ni r),��he or p'(yGF/ [yYbirlslrr-', I t fit
Gecn•ician,,,_��—:`_�_ 'I�tumber_ _
�_^��--•`--"-•-.----�,—,— __'"--••—.� hlerhankad�.��lJ � _Roofer ,.
T hereby ZicknOWledge that I have; read thh-jillclutat~-� ` ' _._w__-___—,— .____,•_ _�--
cOnlpfy wiq, ail re(uireniutl�'corltalned herein alultcioln ordinanr! that the above information is crocllpiet,:� _ � _ _ -"...
l r aY'Id CGI'1'eCt, f 91,00 to
j)i'['(IILl IS l,gl:'1r8t1 1 1,11'1%It,. It; lllS't>(?qll lk'1(SI illl(I ISSCYCCt" � rlll(I :;fate law, regcclating puiilt;:•:0 t:u,lsfrur.,tion. ): tcnow t.h;,('ay
Print AIII, L7l��`!
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