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HomeMy WebLinkAbout606 LOCUST GROVE DR - APPLICATIONS - 10/20/2016Planning,Drvelopment `?- transport: t`iOr ?_.8:1. N. College Ave P.O. So., 580 '.:r ' 1 .1. Fort Collins, CO 80524 �.,_.s �.,. Phone 9%0.<<10 Li'�FO Fax 22_.-1...6:!.34 v 4.._.-. r t i� •�?/ L7 �l 7f' `'' wu '-'%Y" ,i,�y �1.,�) 'r� ;iJ i 1-a J piii anion is o v� risacl io apply :orthe fo.11ovliing permits only (check all that apply). ;-'I Air Co,'Idii:icninc; ! iJc?I'1plitiCln (ir: ,'I"ieil" r C,n-StrUCtl.lr2!) Cl Electrical Alteration (not Serdice change' ❑ Gas L.igl�t:1!' !_:1 Gas Log !;� J11it 0 L.aw;! � Sl:rinlder 0 Mobile Horne replacement ❑ Rooting C7 Sewer Line ❑ Photo vc)it'c;i i/i I,,; i 1lilC!: u watei ! leater !:! Water Line L.1 Wood/, ellat Sto o (Must be EPA certified, provide make, fr1CCl ! c1i;C; ri 1 L-1 n i. is ctLl l;•'i-) . , O!iip!::t'' ail :.li l)iiCa�Jl? illiCri'T18tiOn U1 the applica:t'Cr'J. Incomplete applications livill 1�--- Fa' o5ce use: o/l! — — — �._�-- �- Va ue of Cbd-jst:ru(fdoi) (labor, D iriater"i�:ls, i)Jol`it; v_ g -- - _.�_b ve ._ - - - -..� _............._......_._.. -!a - ......... Owl"lc:i' !� ;- I -.�•. �'.; :.y i\.c . �� Address City/St:ate �II7 �1D1� --- - .. 'll! nc. , -�0I0 _ _ _ .._._y.. ..........._.._............... ---._............. _._._ ._. _ _ __.._ __._.._.— ,r',;�I:,i!C:al"1'.: I�lani•�- ..•.ra.•rq:.'9`' C . AC1Cil•,'SS City/State %ip :7I r`J !✓� A� �Y , y`•x� jfJ .w'.:�,,,� ""]•� " f`��' ✓•1! —` Address City/State �1P ev �' b-d ;..r Zl �� _—......_._. le'•=Jr!= _._. ...----..._ +' ..- •—o--��--I Cont:rad-or Cii'1 or Ft.:;011iiis Salas tax lr ijy a,Y cr7rfractcr': ie ...................... ..... ._-- ---......___.._--......_._.._.....__-........_........--....-- --..._._..___..._._..._.__._._._..._...._ ..._.._._.-.---.._._..------ _ _.......... --....�.—.---------.—..._.._.— I ! t:!.il:i jl reSiCl"!L;ili 01• coin 111 arcia: protect? rleSlClCrlticli ❑ CUnlrne iClal il' !' :Sfi!e:l'i icll, is i',:: �ingle c nnily Detached D Condo/townhol'Tle (single Family a1:CilCtleCl� !`i t�..Ij IIc�;S i� Multifamily (apantment) L. Garage _ :.r cnr„nl rcia!, is it: C.i i3anl; El Gar Cl Church ❑ Hctel/Motel 0 Medical office Office i�'i R.eta!i L-I R.est"('urant: ❑ Other (explain) __......_ ! `pill:; bUildi!"19 SO yc:a: or og a cr• more:? 171 Yes U N0 If yes, Y011 may,%eNd to contact Historic: f'r::s�vv-ltivn year was the building constructed? !:lilt+ is for a Li��.ii1J:::707: jJ�.7':rl'?t, what: .._.__._..-------..._._._�� .._.__.-...............�...�..-........_. �. --._.... i. N 11. J, you LJ'!.i i7E'E'!l r i% asL2uslns a.s5�,_sme/%t to submit V/ith t/�i pp/ir_at,'o!J. Q--- .... ....... m___ .. -e. — -- - - _........ ..........- i -- - - If first-time iVC mr.rst list licensed eiectricia. �''!:; lawn s;ril;icic:!;'bac:<r,rnv prwc:.nlsr, -must list licensed plurnl:Jer, , S:ri�co+r.:rz,ctor::: L,Yq C Conlr��nyna:J:eaJ'ctyoil FhCn//ins/icr�nse. :,:....._.... U !_...---.._...................... I.,.nocr — --... ---...... _._._......- -- i Are you paying taxes Here or by report? El Here Are you paying with your trust account? "ZYes f::i ........ --.._... _ -...---.._.._ -- ----- -... - ---- -- -- hareb;: acknowledge inat I have read this application and stat tt'at the above infornation is complete and correct. ' a rea wi!:ii ;i!I !-c'ii!.1 !'�'%l'!11�5 contained herein and city ordinances and state laws regUlating buildin constrl.le.:lIc.;11. IT i(1iiJ41!'t._,,.i: "r.'! j "_rr iir is riot V71 id in IT,, it 9'ic S iJeeS pail ai1Ci issued. 7 i ' .>� • Prim. Nz�me`�..i' !.; c:(,�� ��"�i_'• ���r1,,;;:.�Siy�aLure� ���!�.:'3...:�i 71rtiate