HomeMy WebLinkAboutAPPLICATION Vacation Home Life Safety Inspection 1086 Pine Knoll DrTownofEstesParkVacationHomeLifeSafetyInspectionA)pIica+t4VacationHomePhysicalAddress:1°6k/yeLLOwnerName:N..tCt-(QL’tJ/c/j4?’MailingAddress:£‘tI5549tf1”1i/4r(Street)(City)EmailAddress:eAA%tf.‘0PropertyManager/LocalRepresentative:IA(/fit0EmailAddress:d;rtc/oa4j,.‘,1’AiI0tMccNumberofBedrooms(perLarimerCountyAssessorDataandVacationHomeLicenseApplication)IdentifySleepingAreasotherthanBedrooms(den,office,familyroom,etc)_____________________DescriptionofWork:2015IRCAMENDMENTSection327LIFESAFETYSURVEYIthehomeowner,orPropertyManageractingonbehalfofthehomeowner,certifytheinformationonthisapplicationistrueandcorrect.Iunderstandbysigningandsubmittingthisapplication,IagreetohavetheabovepropertyinspectedbytheBuildingOfficialtoensurecompliancewithlocalordinances,stateandfederallawsaswellasbuildingcodes.AitIly,InderandthatIamresponsibleforanyfeesassociatedwiththisapplication.Signature:___________________________PrintNameDate:i724z(Homeowner/PropertyManager)***OFFICEUSEONLY***PermitFee:$200.00CountyTax:i.flisfl$0.00BuildingOfficial:Date:Total:T’’1_f)70z_2_$200.00LSIChecklistInitials:Date:Issuepermitnumber:VHLS:EXPIRES:Emailhandouts/permitnumbertoOwner!PropMgr/TownClerkInspectionScheduled(Calendar/Laserfiche/TownClerk/CD-VHLSDatabase)InspectionfollowuptoOwner/PropMgr/TownClerk(viaLaserfiche)FinalInspectionScheduled(Calendar/Laserfiche/TownClerk/CD-VHLSDatabase)ResultsofFinalInspectionenteredinLaserlicheIssueCOtoOwner/PropMgr/TownClerk/PropertyFileFieldApprovedforCertificateofOccupancyby:Date:RETURNTO:towncIerk(ãestes.orq,TownClerk’sOffice,P.O.Box1200,EstesPark,CO80517RECEI\EDTIME:(State)(ZipCode)(pleasewritelegibly)Phone:303—9/07085//(pleasewritelegibly)Phone:303-30/-5Updated07/2021