HomeMy WebLinkAbout200 E. SWALLOW ROAD REZONING - 33-06 - CORRESPONDENCE -"YY�•K,nM(`r,�^�Trw...nd:-.rt�-�^ �rnvn>.n•a`.gKl+.v:... ,. •..m•r..•�,, .. v� ,,,.�.. �. ...... ,,. -,
City of Fort Collins
Community Planning and Environmental Services
Building and Zoning Department
REFUND REQUEST
I hereby authorize cancellation of said permit and/or plan review fee. I further state that no
work authorized by the above permit has been done. I am requesting that applicable fees be
refunded.
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Signature of Applicant Date
33-Ob
Permit Number Application Number
To Revenue Officer: You may authorize payment in the amount of:
Type of Refund
5/ 0 . n/
$ no
Total Amount of Refund
Comments:
Plan Review Fee 101-341113
Permit Fee 101-322101
City Sales Tax
County Sales Tax
Contractor License
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101-231714
101-231719
101-321601
101-3q Illa
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Mail Refund To: �u Sin n hSnn
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Authorized Signature
WHITE - ACCOUNTING YELLOW - CUSTOMER PINK -FILING GOLDENROD -FINANCE
281 North College Avenue - P.O. Box 580 - Fort Collins, CO 80522-0580 - (970) 221-6760 - FAX (970) 224-6134