HomeMy WebLinkAbout612 E PITKIN ST - CORRESPONDENCE - 9/9/2015Cityof Community Development & Neighborhood Services
Fort Collins 281 N. College Ave. Fort Collins, CO 80522; Voice: 970-221-6760
��- FAX:970-224-6134
CONSTRUCTION WASTE MANAGEMENT PLAN and DOCUMENTATION
Note: Environmental Services staff is able to assist with questions about getting a recycle program
implemented, and will also provide education and site visits upon request (call Caroline Mitchell at (970)
221-6288).
PROJECT INFORMATION
Address in 12 E a.,St 91 t kir-n Date 15
Permit No.
General Contractor & Contact Info: Lm FAQ r VCt I IP.vI CYa +tS rn.a.h
13ay t' S6)rGl.im G010 -g52G
Material
Vendor hauling the
Facility recycling the
Total.`volyil,e or`We104,
materialZ
materia13
_`_of'inarial4`,___::__,
Concrete/Masonry
WaSte G,-)m%ens
Fort Col l l nS Stree-I
-
Wood/Lumber
�N ask G-hcas-ers
H m e rn6th Ear+�,
Metals
Was-i,e C�,aS errs
RyLk3o r = ro n
;.
Cardboard
i/��{�GLSet'S
Lori (�llinsRec�cli
Trash 1
w asi-2 UACLS-p,�
N/A-
Other(describe) i
�q�
+
l
CFfie:e,
Required Documentation4: Provide signed documentation from the hauling company that the volumes &
weights listed above are accurate. If you hauled the materials yourself, attach tickets from locations receiving
the recyclables. DocumentatioFris re uired in order to receive final proiect approval from the City.
I and my it -licensed haJawere
ify that the above materials from my construction site were recycled in the
volume / t described taken to the facilities described. �n _
�L� /
Signature (Contra for or Owner) Date
Signature (Licensed Hauler)
Date
'At minimum, the four listed materials must be recycled.
2 Enter vendor name and phone number. If the applicant will haul the material themselves, state such.
3 Where will applicant or vendor take the material for recycling? Enter facility name and address.
To be completed at the end of the project. Please re -submit this form at end of project with these sections completed.
Rev 1115114