HomeMy WebLinkAbout816 E LAKE ST - APPLICATIONS - 5/6/2015May. 6, 2015 2:22PM ADVANCED ROOFING No,8339 P. 1
City of planning, Deve�cp,m;ent &Trarsportaticn
{ j . 7-81 N, Collere Ave P,O. So--So--580
F(5r*t L Collins Fort Coil,•n<_, M c,'H;R4
Phone
OVER-THE-COUNTER PER ri s ONLY
This application is to be used to apply fcr t^e following permits only (check all t",at apply). ❑ Air Condrionirrc
❑ Derr;ciition (ir erior non -structure;; _=!6c"Icat Alteration (not servic-a charCBj _ Gas Lig^ter ❑ Gas oo
C Heating Unit W Lawn SJrnkler t.: iMobi16 l-!ot;,e r2rlacerent ❑ FoornO ewa. Line ❑ Phcto-vc!talC
C Ventilation C Water Heate, ❑'Hater >_in= 711 WcodiPailet Stove (must be EPA carifked Provide make; model inns
manufacturer).
Ccmpfe*e,a(i aPclic fe it(} .�,,rm io^ i:��oi licaticn. lncorplete appiica"'•cns will nc: be acoepted.
APDIi�� o Y1 �i _1)-
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Property Owner Name
Zip ��(y( Phone
L
Fpk2nt N ';E Q Address
I3vAI�GCp PDJ�!NC:
—?�F9
C:rN�Swie 7n Pn Cne Rib
p
^TLGiktJ l G.�-.CS '"1�go ��- `tip
�]42 e, 1Ni��•1�? r'rJ �_(;,
ConL accr Uc
yip Phone
Centrctcr City of ; b Collins Sales Tax =
Are you paving t-,x2s here or by r-perr? Her 0 Report
NestFx
?.re yGu Payir:C Wft1 yc: 7 "'. ac �•ln"t G Yes ❑ No
Is this a residential or commer�a! __.ce;,gal ❑ Ccmr erda!
L-' residential, is it;Sirc!er,GG,/tcwnPioe ndi2 2, ,} a==_ ;e• ,
n(-=i•' fi; r Duplex
❑ Muitramii•/ (acatent` Garage
Ii crcmerciai, IS r; 1] Bank ac, r C,�u-._;!'`! c---:C=
/
C Kea�:Urant I J�-1Mr 'E,n7ain%
^1 S
Is this building So vea. = of ace or rer=? _ ''e'; C he h`y�s, yuu / 2j nssC -c :., .-; n; crc Preserve: er,
If this is for a demeliticr per ,tit, ar; ,_t y_;- �, _: th5 buiicino con_^, �crcd?
°pr,'cr to 197S, y'co• w;,'// /1 an Ecf=Y ..x ..... _ .ni—), :J 74vrie rrl r, G';,s
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Desc; ioi;;Cn or 'r,cr-< � , :.,- . - :_ -: - � cam' = ',>,zr...�_.:. -
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fT"--jMe A.1�'--
Su> ccntra-�crr:
I hErecy -cGc v i e,7 vL_
PGi .. ne :]
Comply w u`t till r eq-0r` Er." (' Et'. : ^. ,Ca ar +_ ! ,_ .J
c:Tt C,; ivl%2C ^, E. , ai ;^. ,'ir:G' S .. ,d 'at. ;aI' ,-Liv[iiCr^r.E:'_C:iC;'I,
I {C;TOW t:i;Zt a
permit is not Valid unx;i;t has been 'Ja:U an,:
ni_ '7v�eJ.
Print Name: 1i _ a:, a`,-e.__�\''. 1 z�Q
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