HomeMy WebLinkAbout874 CAMPFIRE DR - DISCLOSURES - 3/6/201406123/2013 18:37 FAX
Q 0002/0002
--------------
FINSULAITI"ON
iResideettl8l Energy Cade
bISCLOSURE �ORlN
�srmar _ n err,
Job address:
General contractor:
Insulation contractor.
the building & zoning dept. of
Community Plerming and Environmental Services
281 N. Cd44 Avo., P.O. Box 5W. Fort Collins. CO 60522
V 6T0 221 6760 FAX: QM224 6134
�I re
INSTRUCTIONS
This disclosure form is to be signed by the Ineulation contractor or representative of the general contractor.
Please type or print
except for the signature . Complete the information in the appropriate spaces provided.
rf eomponstlts vary, make multiple entries to descrtbe them.
One copy of this form must be provided to the Building and Zoning Department prior to the c.o,
One copy of this form must be made availebte to rho original home buyer.
Insulation
VVVe Dertify «t the ae"p vated rnWalton was installed In the bwftng at the above iocatiorrs ut rorttormance ,with ttTe currant requirements of the
F `'9Y Coda, and that it was installed in aecardanca with the Insulation Guidelines' published by the City of Fort C.oiiins,
Person CertifyingN---
1 `11 w
V "rt C.