HomeMy WebLinkAbout4307 MILL CREEK CT - SPECIAL INSPECTIONS - 12/14/2006Community Planning and Environmental
Building and Zoning Department
Q s 8SIZ
PERMIT AND INSPECTION REQUEST FOR
EXISTING NON-STRUCTURAL CONSTRUCTION
City of Fort Collins
Please print or type
Address: / -/ 3 o. 1 M �
Date:
I/W E CC k-. as owner(s) of
record of the above property, hereby request a permit for and final inspection of the
installation or construction work described in the following building permit
application, which work was completed or covered without obtaining a permit and
without required inspections during construction. I/we understand and agree that
the City of Fort Collins Building & Zoning Department will perform a final inspection to
assess compliance of such work, some or all of which may be concealed by
permanent construction and finish materials, based on observable conditions and
nondestructive methods: and, that it may not be practical or possible for the City of
Fort Collins to verify full compliance with City building codes without removal of such
permanent construction and finish materials. I/we further understand that any
violations of City Codes related to health and safety associated with the above work
or installation may require correction.
Work performed by: UO knowA..
Name Address
Date work perform
(Signature �� Date T cC, /�fr ZDG 6
(Signature)
For office use only:
Permit/Application Number
Date applied.
Date
281 North College Avenue • PO. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134