HomeMy WebLinkAbout1439 REDBERRY CT - MISCELLANEOUS - 2/19/1991City of Fort Collins
Services
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.
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SIGNATURE OF APPLICA DATE
I-) l K; 2 �'-C
PERMIT NUMBER APPLICATION NUMBER
To Revenue Officer: You may authorize payment in the amount of:
Type of Refund: / a . 00 Plan Review Fee
Comments:
/0Uv
s 19-0 Ov
Total Amount of Refund
Permit Fee
Sales Tax
Miscellaneous-`%
Ff 66111d , � G(j
/ � C)U
3cs a
*Attach copy of Application AUTHORIZED SIGNATM
or Perms[
300 LaPorte Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (303) 221-6760