HomeMy WebLinkAbout927 SNOWY PLAIN RD - APPLICATIONS - 7/9/2018281 N. College Ave P.O. Bias 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
ibis application is to be used to apply flor the ollowaig p°_rmr{s only (check all that appal. 0 Air Conditioning
0 Demofitiort (Mmior non-structural) 0 Electrical Alteration (not service change) 0 Gas Lighter ❑ Gas Log
0 Heating Ur]rt Lawn Sprialder ❑ Mobile Home replacemeni ❑ Poomtg 0 Sewer Line Q Phoa&voltaic
0 Ventilation lA/ T ter Hea0 Dilater Line 0 INood(Pellet Stove (must be EPA cerlifred, provide make, model and
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Complete aU applicable 'mfvmm+ation ou the appficatico. LucorgAete appFx;afions w--sg not be accepted.
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Appficaion - :. '� ��� 53a°� Date 7 -- 9 -I S'
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Property Owner name AddMss
Cr1y/Stale }C0II IYEzip
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Applicant Name Andress
City/Stale Zip
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Phone 7
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Con cT`�or Address:
City/State Zip
Phone
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COnt idCLOr City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? 0 Here
❑ Report
swig tax mwbu is rim by ae oonr�..
Are you paying with your trust account? 0 Yes
0 No
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Is this a residenttal or,eommerciai project? Li Residential 0 Commercial j
If residential, is it AS!ngie Family Detached ❑ Condoltnwnhome (single family attached) ❑ Duplex If
0 fluiFTamily (apartment) 0 Garage
If commercial, is ii Ci Bank ❑ Bar 0 Church 0 Hotel/Motai ❑ Memel office ❑ Office 0 Retail
0 Reit+aaat Ct Other (explain) _
is this huAtg SO years of age or more? 0 Yes 0 No if yes, you may need to tact Hiismix PresevatiM i
if this is for a demaafifiDn perwk what year was the budding constructed?
If prior to 1975, you will need an asbestos assessirnent to submit with this application.
Description of work
*If lam /moo"" preienter, MISE list fiaMSed piuntxr_ if first rirne A/C, must list kffGao electridan-
S: conuadurs: Lst the Company name or City or PL Collins license
I hai2by admowledge that i have read Huss application and state that tt�e above irdtumation is complete and corm I ag2e to
comply with ail requirements contained herein and city oxlinau and state laws regulating building tonstrucWn. 1 know that a
` pernfit is not valid imlu it has been pe id and "issued.
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Prirri. fi1�ne: i signature o,Oate