HomeMy WebLinkAbout3715 Shallow Pond Dr - Applications/Demolition - 06/21/2017Cit Of Planning, Development & Transportation
2111 N. ge Ave P.
Fort Cothns Fort Collins, CO 80524 O. Box 580
`- Phone 97"16-2740 Fax 22+6134
DEMOLITION PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).
X Demoldion-interior non-structural
0 Partial Demolition of existing building
O Demolition of entire building or residence
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # k 1 770-N "fib
For ot➢%e use only
Date tol
lob Site Address (iequlied) Valueonstrudion (labor, materials, profit)
3715 SHALLOW POND DRIVE FORT COLLINS CO 80528 �V - 00
Property Owner Name Address City/State Zip Phone
KELLY RYAN E IRREVOCABLE TRUST 3715 SHALLOW POND DR FT COLLINS CO 80528 913-490-6589
Applicant Name Address City/State Zip Phone
BOB D PETERSON 4803 INNOVATION DR STE 1 FT COLLINS CO 80525 970-225-2323
Contractor Address City/State Zip Phone
ASSOCIATES IN BUILDING & DESIGN LTD 4803 INNOVATION DR STE 1 FT COLLINS CO 80525 970-225-2323
Contractor City of Ft. Collins Sales Tax #
Sales taxmmnberlsMgL* dby04ca►b8dVM 25805 Are you paying with your trust account? O Yes No
Is this a residential or commercial project? % Residential 0 Commercial
Is the demolition of an upcoming 0eve%amen[Rertlenrproject? Cl Yes jl(No
If residential, Is It: 19Single Family Detached O Condo/townhome (single family attached) O Duplex
0 Multifamily (apartment) ❑ Garage: Square footage if detached NCI COD
Number of dwelling units to be demolished:
If commercial, Is lb 0 Bank 0 Bar O Church 0 Hotel/Motell O Medical office 0 Office 0 Retail
❑ Restaurant 0 Other (explain)
Is this building 50 years of age or more? 0 Yes JI(No -$ �� I in 20011'p
Type of New Building Planned: 0 Single Family Detached O Condo/townhome (single family attached)
Cl Multifamily (apartment) 0 Duplex 0 Detached Garage 0 Commercial Mixed -Use Building
Description of
Square footage to be demolished:
Subeon ctors: Llat the c ampmrny name orClly otR Colons //tense 0
sedridan ba plumber ffJM Mechanical N /A Roofer NT Other
I hereby acknowledge that I have read this application and state that the above Information Is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building eonstrudion. I know that a
permit is not valid until It has been paid and issued.
Applicant: A, I
Print Name: MUSDO 34tykS '1 SignatureDate 7'i
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