HomeMy WebLinkAbout4702 DUSTY SAGE DR - APPLICATIONS - 6/6/2003BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
C
03 Street Address Please Specify: LN. a CR. WY. PL. ST. CT. RD. AVE. CI
Company Nam Vft, 4License umber
0
Mailing Address &6n", $t t
C 0l�
6 Phone T ` c
- y tJ 'Z
1 Plea a Specify.- LNN. CR. WY. PL. ST. CT. RD. AVE.
`l64-Z —1) u % &4cj�
Pho�n/e
17 /I
State ZIPCode
c c�
Sales Tax Number
Z3�L�Z
7t C -
- C
CP
P
Subdivision/PUD �\O
�l
*PARCEL NUMBER*
CM
Filing Number Lot
Block
Lot Area t3
Building Square Footage
Number of Stories
Building Height
C
O
Bathrooms
Finished Footage
Number of Dwelling Units
Number of Bedroo n are
5
Stock Plan Number
Option
y
Water Tap Size
Sewer Tap Size �-
Metered
m
Typ Heat:
Electric Main Breaker Size (Residential Only)
Gas ❑ Electric
0150 amp or less ❑ 200 amp
❑ other
Value of Construction (including labor, material, profit)
Description of Work: t—kQl-514
nn�
Subcontractors:
Electrical ,V�Mechanical �QZXW C.�Plumbing 14tacg Roofing
I hereby acknowledge that I have
requirements contained r
1=
o. Signatur `
a
a
Print Nam
this:
his a ation to that the above information is correct and agree to comply with all
ance to laws regulating building construction.
PhoneZZZ '?��—
Distrbution: Original - L & P Green - Office