HomeMy WebLinkAbout4700 INNOVATION DR - CORRESPONDENCE - 9/27/1995r.1.'�1i:4''tln.+.-^'u+Y.r.Yy; Wtivw4r.-a-.--.•,......... vw.�.. ... ,.nman.a o,+
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Community Planning and'Environmental Services
Building Permits and Inspection Division
CITY OF FORT COLLINS
BUILDING INSPECTION DIVISION
City of Fort Collins
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.
Signature of Applicant
Date
6?r5-1oy�. y
Permit Number Application Number
To Revenue Officer: You may authorize Payment in the amount of:
Type of refund 161% 2
Plan Review Fee
Permit Fee
Sales Tax
Miscellaneous
Total Amount of Refund
Mail Refund To•
*Attach copy of application or permit
101-.341113
101-322101
• 4
AUTHORIZED SIGNATURE
281 North College Avenue a P.O. Box 580 a Fort Collins, CO 80522-0580 a (303) 221-6760
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