HomeMy WebLinkAbout829 S Shields St - Correspondence/Plans Approval - 03/16/2015Cltyof Community Development & Neighborhood Services
� rt CoWn 281 N. College Ave, Fort Collins, CO 80522; Voice: 970-221-6760
e r g FAX:970-224-6134
CONSTRUCTION WASTE MANAGEMENT PLAN and DOCUMENTATION
Note: Environmental Services staff is able to assist with questions about getting a recycle program
implemented, and will also provide education and site visits upon request (call Caroline Mitchell at (970)
221-6288).
9 Zi S . glli e(6s
Permit
General Contractor & Contact Info:
PROJECT INFORMATION
fv-v�leov,J SeeTte.J 9%o V& Z 1976
Material
Vendor hauling the
material z
Facility recycling the
materlal s
To I'`uo urr'eo�rwei ht'
s Hof m-0,¢bdoll
Concrete/Masonry
01��r6j; Son'171h
V ►L21r Cb VIS1
I442 N Tim ril) e
Wood/Lumber
C4l �t os SU►�ifi�fla,
Metals
Octp�/) /� (�j�
ct I le s So k? ifA
Vim✓ /��OPIS I VG1-7 �-
V
i Z
Cardboard
cl
Trash
N/A
W
Other (describe)
Required Documentation4: Provide signed documentation from the hauling company that the volumes &
weights listed above are accurate. If you hauled the materials yourself, attach tickets from locations receiving
the recyclables. Documentation is required in order to receive final project approval from the City.
I and my City -licensed hauler certify that the above materials from my construction site were recycled in the
volume / weight�d/es�crribed and were taken to the facilities described.
Signature (Contract' r or Owner) Date
AMU s
ure (Licensed Hauler)- Daf
'At minimum, the four listed materials must be recycled.
2 Enter vendor name and phone number. If the applicant will haul the material themselves, state such.
' Where will applicant or vendor take the material for recycling? Enter facility name and address.
4 To be completed at the end of the project. Please re -submit this form at end of project with these sections completed.
Rcv 1/15114