HomeMy WebLinkAbout417 N GRANT AVE - CORRESPONDENCE - 9/1/2016City of Community Development & Neighborhood Services
Fort Collins 281 N. College Ave. Fort Collins, 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 i/I 17 N � r�d`'I �"`" Date
Permit No.
General Contractor & Contact Info:
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of Vo4lyoY)-3
Material
Vendor hauling the
materia12
Facility recycling the
materia13
Total volume or weight
of material
Concrete/Masonry
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-T
, S
Wood/Lumber
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e (IM
144
Metals
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Cardboard
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Trash
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N/A
Other (describe)
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. Documentation is required in order to receive final protect approval from the City.
I and my City -licensed hauler certify that the above materials from
volume / weight described and eyv re taken to the facilities described.
Signature (Contractor or Owner)
r4S
my construction site were recycled in the
Date
Signature (Licensed Hauler) r,, 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.
4 To be completed at the end of the project. Please re -submit this form at end of project
with these
sections completed.
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