HomeMy WebLinkAbout4960 DAKOTA DR - APPLICATIONS - 9/16/2004gh
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com
BUILDING PERMIT APPLICATION
3 Street Address Please Specify: LN. DR. CR. WY. PL. ST. T. RD. AVE. City State Zip Code
Company Name / License Number Supervisor & Cert. #
Mailing Address City State Zip Code
Phone
/
Please Specify: LN. DR. CR. WY. PL. ST. CT RD. VE. Zip Code
JOB
SITE ADDRESS
t
Subdivision/P D �/
' `�4
°i
Filing Number Lot Block Lot Area
Building Square Footage Number of Stories Building Height
Finished Basement Square Footage
Number of Bedrooms/Bathrooms
Value of Construction (including labor, material, profit) $ 00
Description I Wor
AVC=!/✓ /�J 'c_K 6WV,�T10 C- j /a/� Oy�'e �X/ �J� ✓�r9-%%.
Subcontractors:
Electrical Mechanical Plumbing
Roofing Concrete Framer
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contained he nd ci ordinance tate laws regulating building construction.
A
a Signatur
Print Name Phone
Distribution: Original — L & P Yellow — Office
_ - THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE