HomeMy WebLinkAbout1765 Concord Dr - Applications/Reroof - 02/16/2017From Affordable Roofing Inc 1.970.207.0289 Thu Feb 16 11:55:24 2017 MST Page 2 of 2
aty ri Planning, Development & Transportation
281 N. College Ave P.O. Box SBC
cart Collins. CO 80524
Phone 970416-2740 Fax 224-6134
®1/ER-rTt9EPAWCOUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). C Air Condkioning
0 Demolition (interior non-st uchlrep ❑ Electrical Altaratkm (not service change) ❑ Gas Lighter ❑ Gas Log
t7 Healing Lin? ❑ Lawn Sprinkler ❑ Mobile Home replacsmani Cl Roofing ❑ Sewer Line ❑Photo-volialo
❑ VLAft-lion ❑ Water Hester ❑ Water Line a Wood,Pellilt Siove (must be EPA carMed, provide make, model and manufacnl:arl.
Complete all ap able inttoor(maatlon on the application. Incomplete applications will of b acceated-
Apolimton i Dave
ordrnlce usedrJOQ* ' --
Sob Site Address fre9uued) Value of Construction (&ar. ma:• i s.. x�eri
PmPertsi Owner Name Address GtYi%J
state p —T—irons
Name Address City/State 'Lip Phone q-j()
t . r) r)
cm-lba=r _) Address jy/State Zip ?hare
Contractor City of R. Collins Saies Tax
Are you :eying with your bust amwnt? Yes ❑ no
is this a residential or commercial pro(ed? '2,Regoentfal ❑ Cammerdal
i !f resluendal, isR: Single Family Detached ❑ Ccndo/townhome (single family attached) ❑ Dupinr
- ❑ Multftmily (apartment) ❑ Garage
if commercial, Is I' ❑ Bank ❑ Bar ❑ Church ❑ tlutelJMotel 17 Medical ottke ❑ Office Cl Retell
❑ Rtstaurani ❑ Other(explaln) _
[s this b tiding 80 years of age or morc7 ❑Yes G No J; yet you mayneed Jfl mnracthriC tlat
rf,his is for a demolition permit, what year was the bullding constricted?
ff n-!or tel I973, You evil! need Or ashaRVS essrssYW?t tb subaUt whir rhls agrticerm z
Description, of
*If lawn R Vent
spnnlrl�/barJcnow RventBl, must list licensed oiumber. if nest-.bme. A/C, ;nusi Ua[ acer:sal eleCirkian. ,
Subcbntmc''om L&r Dire mmraay nanro a-Gly arft Ca%,, hjY.,, 1
0Qc! d-.nPkunba_.- Ma 1`1 col,,. RooW.-z=1 O J 1_ oft
t iM goy eamowrmge ;tort I have read this application and rare that the above inrwmotbn is Complete and correm i agree to
OMMY with al: requhpmpnts contained herein and city ordinances and slate laws regulating building ov stwoSJwr. I know that'.
parrot: is not Valid until it has been paid and laurld.
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