HomeMy WebLinkAbout318 Canyon Ave - Applications/Correspondence - 04/05/1985P.O. Box 580
Fort Collins, CO 80522
CITY OF FORT COLLINS
NOTICE OF BUILDING PERMIT APPLICATION
Building Address
PROPERTY
LEGAL7nr���D7�L
.Subdivision or P.U.D. Filing No.
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DESCRIPTION
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Lot
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Corner Lot:
Total Street Frontage (linealfeet)
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Name
Phone
CONTRACTOR
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Address City State Zip Code
22� U • Pesos � • Cv (� � �� Zs
Name
Phone
OWNER
Address City State Zip Code
C�{2S i 8055
Single Family ❑ Commercial Lf Number of Units:
USE OF
BUILDING
Multi -Family ❑ Other:
TYPE OF
NS 0.00
Gas Electric ElHeat Pump ❑ Baseboard Radian0
HEAT
1U0therrl
*ATER AND
SEWER
Water Tap Size:
Sewer -Tap -Size:
e[ered Flat Rate ❑
„
Draina Basin •
Gj Area f
STORMWATER
BaSe Rate
Runoff Coefficle t
or
Floodplain
UTILITY
Yes No
(T%be
Utility Fund Number
Storm Drainage sin Fee
completed
by otheral
Storm at r Utility Signatur
NOTE:
I understand that the Storm Drainage Basin Fee must'be paid prior to the issuance of a Cer-
tificate of Occupancy. I further understand that if drainage improvements are required4or
this site, two (2) copies of a drainage report and a drainage plan, signed and stamped by a
APPLICANT
Colorado -registered Professional Engineer, must be. submitted to the Stormwater Utility for
approval before a Certificate of Occupant will bessu d.
Signature of Applicant:
Date: r
DISTRIBUTION t. Original: Applicant — 2. White: Building Inspection — 3. Gold: Stormwater Utility — 4. Blue: Transportation Utility
— 5. Pink: Light & Power — 6. Yellow: Water & Sewer
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