HomeMy WebLinkAbout612 BALSAM LN - PERMITS - 8/9/2006is Community Planning & Environmental Services BUILDING PERMITPERMIT FEES
Building & Inspections Division
M- P.O. Box 580 281 N. College Ave. Building valuation
Fort Collins, CO 80522-0580
c3xv of Fen ceutns phone (970) 221-6760 Fax (970) 224-6134 g 0Q3830 ACCOUNT FEE DATE PAID
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3 SITE ADDRESS
TYPE
o '' 6 Building Permit w/o Sub $29. 0 81,910
CATEGORY TYPE
Residenti 1 _City Sales/Use Tax $26. 5 8/9/0
Construction Type Occupancy Group
County Sales/Use Tax $7. 0 8/9/0
w0 No. of Stories Building Height
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No. zBACaeeNomber Zoning District (See reverse side for Inspection Description)
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7
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TEAR OFF EXISTING SHINGLES AND REROOF WITH 16 SQUARES
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As 6 condition for the issuance of a permit, I hereby declare that I am an owner or the owner's agent, authorized to perform the proposed work on the property
described herein. I agree to comply with all City ordinances, and State laws associated with such work. I understand that such permit may be revoked in the
event that issuance was based on incorrect or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced, suspended, abandoned or inspectetl within 180 s it he date of such ermit or from the date of the last inspection.
Print name of owner/agent Signature Date TOTAL FEES