HomeMy WebLinkAbout901 GROUSE CIR - APPLICATIONS - 2/16/201702/16/2017 14:14 19702241211 ROCKY MTN ROOFERS PAGE 01/02
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281 N. C.opage Ave P.O. Brae S80
Fart CAM CO 80524
Phone 970-416-V40 Fax 22"1M
THE4=N1MR PMMITS ONLY
This aeon is to be ib N" for the %Mwbtg p mnkb 0* (dmwk as that ems. 0 Air Cor g
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0 Demof o Amon (not mvim dwW) o Gn LWOW o cos we
0 Heaft Lkd O fawn O Mobile Flame replaoernwd 0 sewer uns 0 PhOWAMtmio
0 Ventllation 0 Water D Ws wr L kw ❑ WoW Pelet Shwe (mast be EPA oerf lied, provide make, model and
Corrrpla� ap ap471e ern the applicodon. Ineanplais a00Baadarie wt® not be aeceeted.
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c.u.:dx C]ty of Ft: Cobs Ta x d 44 ! 3 T(o Are you p r#* taxes here or by report? O here dt Report
Soer�nxaneer�sreRrredDyad Are you pelt we Your oust MmuriCt A Yes O No
Is this a residential or
if residential, is it: '®
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is tuts trugdtng so vem of a
1f ihts is far a derrroll SM 04
lip wta 197-1� you xv7/n m
of work
W project3 d RMiandal d Canw dal
Deradred CJ ( alladwid) E3 Duplex
n* ( ) E3 Garage
E3 Der a Church o A*WJMM o aflca a Ofl'ioe a ReW
mitt o other (awe+)
Nor more? ayes IPNo D'Yerr Y� mal'masd ro gp�rbct/ lr7rxPYesr3v. an
mk what Year was the b &** cxWucbW
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*if Bon s kwar/wKwarr pen ersW, must It 6oawed Pk0Ibw. rf fkU-d a NC, Mu3t W Ooensed e[edSidan.
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I hereby adrxmWdF #wt I h read this app6retion and � drat the aov be odbrmatln b oo on�plme t .
Oprn* with d regAmnerds tied hereb+ and � ordnd e�trea astile Inns regutetlng twadbg
p 1, a is oat vaBd and It b been paid and issue. •. ,
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