HomeMy WebLinkAbout932 E PITKIN ST - MISCELLANEOUS - 10/26/1998r
Citv of Fort Collins
Conununity Planning and Environmental Services
Building Permits and Inspection Division
CITY OF FORT COLLINS
BUILDING INSPECTION DIVISION
I hereby authorize- canclyllation of said permit and/or pl n review fee.
I further state that no work authorized by the above pertiit has been
done. I am requesting that applicable fees be refunded.;
Signature of Applicant
Date
Permit Number
pplicat
To Revenue Officer: You may authorize' Payment in
Tvne of ref„nd �_
Plan view Fee
o
��ermit F�
Sales Tax,
*scellane us
Total Amount of Refund
Mail Refund To•
�r—
*Attach copy of application or permit
amount op
101�341113
104-322101
90000
AUTHORIZED GNATURE
281 North College Avenue • P.O. Box 580 a Fort Collins, CO 50522-0580 • (303) 2221-6760
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