HomeMy WebLinkAbout612 ZUNI CIR - APPLICATIONS - 11/16/2017Nov 16 2017 0715PM HP Fax 9706130826
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�f�tyo�f ,,���t Planning, Dev�elopmen4 & Transportation Swvkw
CoWm Community Development & Neighborhood Services
281 Mort College Avenue
Fort Collins, Co 8w24 Mein: 970AI6 2740 Fex 970=4.8134
OVER-THE-COUNTER PERMITS ONLY
This appillceson Is to be❑ Der IOMon k(kdwlor n apply for the followingPMnas mar (duck all that apply. 13Alr Conditioning
Heating Urdt ❑ Lawn ) Eler�rical Alterotlat (not service change) C3 Gas Lighter ❑ Gas Log
Sprinkler 0 Mobile Home repkirarrent ❑ Rwbg ❑ Sewer Line O PhotD vdWic
❑ VedWtbn ❑ Water Heater ❑ Wad Line ❑ Woodf 3eW Stove (must be EPA certltied, provide make, model and
merfuttacb.1w).
Compisb at1 appihxbie bNoraw ion on the apocad=L Inaompiate appOcatl
Appuctlw # ?) M'U-j tq j
one win not be acosptat
lob s1Ee ftiddreraa (mr?r atarq Vabre at Coradsvcd n (labor, mouruls, Pn )
foamy oww game eo
address CRY/gabe ap Phone
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APpikant Name Address ay/su to
Zip Phone
Coftacbw Address
(limn WAlistA nna re:.n �AA r._ � aP Phone
Cortb'a�or CILY d�q,n ax 'f YN Paying tares here or by report? Here ❑ peps
sets tsurnvnDa•!r Are You PaYing wtrh your trust aaoourtt? Yes 13 No
Is this a reddenu or co nnerdal project? I R"Wentlel E3 carmmer w
If redderd* b it: 10 Sl%le Family Demdled C3 CorwgftNmhome (eingis family aftdted) 0 Dupla
C3 Mullsandly (apartrnent) ❑ Garage
If con nen:K is Ib 13 Bards D Bar 0 Chwtft CI Hotel **W 13 Medical dBee 13 Woe ❑ MW
13 Restaurant 13 oew ( )
is ttrls building SO years d asp or morel 4 YMIDNOD'yra� Y� �1Y /uetid m Qa7�Ct/tgrlC
If this is for a damlltlon permit~, what year was the building eonWucWdi fan
.�. a T. i . .,
*ff lawn Slwlrklerfbaddbw p►euenter, must kst kensed plumber. It f ut- me A/Cr must list licensed daeMdan.
Submasi b m j&the=*wWn wMdrGltyofR[bdWies,i,ermei
Plumber
noon _ other
I Eby adwvwk dpe that I have read bile appkation and slate that the above and Correct -----
I to
comply with ON re Wrens" contained herein and city ardtrar M and stabs laws replWq building cwdzuctlon. I knew that a
Permit is net "M and It has been Paid and Issued.
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