HomeMy WebLinkAboutAPPLICATION Vacation Home Life Safety Inspection 286 Moraine AveTownofEstesParkfRECEiE’b7VacationHomeLifeSafetyInspectionApIicaior0VacationHomePhysicalAddress:‘‘‘\tOwnerName:LAc-Jc:MailingAddress:c.tL’7C0h’r1%h’os(?(Street)(City)(State)(ZipCode)EmailAddress:L.ic.Y—(7C”-(pleasewritelegibly)Phone:PropertyManager/LocalRepresentative:&—l?Zcl(trt%’SEmailAddress:-A‘ZYD()tt-‘(pleasewritelegibly)Phone:97Z95NumberofBedrooms(perLarimerCountyAssessorDataandVacationHomeLicenseApplication)___________________IdentifySleepingAreasotherthanBedrooms(den,office,familyroom,etc)—DescriptionofWork:2015IRCAMENDMENTSection327LIFESAFETYSURVEYIthehomeowner,orPropertyManageractingonbehalfofthehomeowner,certifytheinformationonthisapplicationistrueandcorrect.Iunderstandbysigningandsubmittingthisapplication,IagreetohavetheabovepropertyinspectedbytheBuildingOfficialtoensurecompliancewithlocalordinances,stateandfederallawsaswellasbuildingcodes.Additionally,IunderstandthatIamresponsibleforanyfeesassociatedwiththisapplication.Signature:‘PrintNamec’tdtDate:U•3oo2:LHeowner/Propertyager)***OFFICEUSEONLY***PermitFee:$200.00CountyTax:$0.00BuildingOfficial:Date:Total:x‘ZDOtIfr/ZOZA$200.00LSIChecklistInitials:Date:Issuepermitnumber:VHLS:EXPIRES:Emailhandouts/permitnumbertoOwner/PropMgr/TownClerkInspectionScheduled(Calendar/Laserfiche/TownCIerkICD-VHLSDatabase)InspectionfollowuptoOwner/PropMgrlTownClerk(viaLaserfiche)FinalInspectionScheduled(Calendar/Laserfiche/TownCIerklCD-VHLSDatabase)ResultsofFinalInspectionenteredinLaserficheIssueCOtoOwner/PropMgr/TownClerk/PropertyFileFieldApprovedforCertificateofOccupancyby:Date:RETURNTO:townclerkestes.org,TownClerk’sOffice,P.O.Box1200,EstesPark,CO80517Updated07/2021