HomeMy WebLinkAbout4806 LANGDALE CT - CORRESPONDENCE - 12/30/1999City of Fort Collins
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Building Permits & Inspections Division
CITY OF FORT COLLINS
BUILDING INSPECTION DIVISION
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.
ou� 130- 9 9C
DAT
APPLICATION NUMBER
To Revenue Officer: You may authorize payment in the amount of:
Type of Refund: Plan Review Fee 10144141
Permit Fee 10142211
Sales Tax 10121714
l-r� I Miscellaneous y-n-L-t�-;\
$ .1QI
Total Amount of Refund
CnmmPntq:
Mail Refund to:
CJ �
k, .
*Attach copy of Application AUTHORIZED SIGNAT
Joe
V
3DO LaPorte Avenue • P.O. box 380 • Fort Collins, CO S0522-0580 • (303) 221-6760