HomeMy WebLinkAbout4425 STONEY CREEK DR - APPLICATIONS - 8/13/201408/13/2014 15:16 9704612547 ATLAS PAGE 01/02
C & d1inS
Murano, ftwefopment & Trwwpm*d:i6n
281 M. College Ave P.O. B= 580
Fart Collins, CO 80524
Phone 970-416-2740 Fax 2Z4.6134
OVER-THE-COUNTER PERMITS ONLY
Thisapoch? ion is to be used to apply for the following penrilte only (check all OW ap*).;O Air Conditioning
p Demo" P(interior rmp-*uctraal) 13 Electrical Alteration (not ser �"c� change) 0 0 Coma Gas Lighter s Log
❑ Healing, Unit 0 Lawn Sprinkle' 0 Mobile Home replacement "i— �0ft ❑ Sewer dine Q Photo-voltate
0 Ventilation O Water Heater 13 Water Lime ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).:
Complete:all applicable information on the application. incomplete applications will nof.be accepted.
Application # I A (l l 01 Date
Faralfm use only ^
Job Site Address (rv9z*vV
Value of Construction pahor% materials, profit) '
1Jc rj- n
CS49
property, O+i ner Name
Address
cry/state zip
PhoneyoD
Applicant Name
Address
aty/statid Zip .'
Phone '
Contractor ;
Address
City/state
4-7777
c1--154
Contrw1w city of Ft. Coffins SOP
Tax # 14,y O'Y6
Are you paying taxes Mere or by col ?:
ere 0 Report
Sshsrarm xziar s dbyaW/annbaciws
Are You paying with your uuSt aocou►it?
13No
Is this a redoentlal r-MmsiuIrWangy
ercial Family
l�esrdeaMfei O Commercial
If rewentiair, is it;gle l am�r � ed C3 Cortdo/hrmhome (single family attathad) 1] Duplex (apvhtr ent) 0 Garage
Ircww aerdai{ is IL 0 Bank 0 Bar 13 Church O HoWlMot al 0 Medical office ❑ Ofitce 0 Reta►l
• ; 0 Restaurant O Other (exwm)
Is this buikt hg 50 yeat'9 0f &9S 0r: M0(e? O yeS ONO. If ya$ yet/ mayneed to awb? 'HiSt01rC P➢r 6iDlt
Itthis Is for $ demolMon.perinfl; what year was the building constructed?
1FA*rfO 1975, you kWl n@ealan mhasivs amwrent to snbm(t NO tfilsaPAkVGan,-
of work'
*I! 1a w sp ftkier/baMow preventer, must list Ik>ensed plumber. If firsVUme A/C, must Rd limnsed elestriaan.
Sub mnbadws: L/st rite =W&Vneme or ay aFJT a is s Ammu 0
Plumber Ma&onkaj Roofer other
i
' Y
I hereby adgpwk* that 1. have read this application and state that the above gribnmtlom is complete and GOnaZ I agree to
comply wtih all requirements contained herein and city ordbom and state laws regulating bu�1dhV'egnsbu�fon. I laww that a . .
permit is irgt: jWM wrhl lthas been pail and:starred. z
ApplicaNaaie Cb CIL
Ddt�.;_ Signnf�Prre oa26