HomeMy WebLinkAboutPERMIT 1754 Fish Hatchery Rd roof 2003-06-17JOB STREET ADDRESS:
(-75-4-PcJ ,-44iti-ISI a4
(V4CAJIC C?*.oJ.J2)S9
LEGAL DESCRIPTION:
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PARCELTD#:3SIGo -oo
OWNER NAME:1Vt4 ci 7’AZA
OWNER MAILING ADDRESS:
?o.3e,’t ,zoe’s--s 7A 7
Town State Zip
OWNER TELEPHONE #:14>lo i se -s-iS,
CONTRACTOR NAME:
io..z1 ci £s7S V42s4
TOWN BUSINESS LICENSE #:
CONTRACTOR MAILING ADDRESS:
SA,nC...
Town State Zip
CONTRACTOR PHONE #:
DESCRIPTION OF WORK:
,le,foc’F ‘77/.(z),-4 c.JC
.,4tcre2.
Valuation of Work:$j,c,o
I hereby acknowledge that I have read this
Application and state that the above is
correct and agree to comply with all Town
Or ances and State Laws,regulating
€oe.ot
—S
—Ss
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The Building Department will make every
effort to prevent errors in your
Application and Permit,but cannot be
responsible for your failure to comply with
all Building,Zoning and other applicable
Codes
___
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BuildinjOuficial Signature Date
TOWN OF ESTES PARK
MISCELLANEOUS PERMIT
970-577-3722 or 970-577-3728
(For small plumbing,mechanical,roofing jobs not requiring plans)
M-Y7-o3
Date ;‘7-rjI
FOR OFFICE USE ONLY
type of Construction:
I-FR Il-FR II 1-HR Il-N III 1-HR
Ill-N IV HT V 1-HR V-N
Occupancy Group
A.B,E,F,H,I,M,R,5,U
Division
1,2,2.1,3,4,5,6,7
Census Bureau #:
_________
Valuation of Work:
_____________
Building Permit Fee:
____________
Larimer County Tax:
_____________
TOTAL FEES DUE:
Prciat
CLASS OF WORK:
ALTERATION
REPAIR
Perittee nature DAte Revised:April 10,200 lBuilding\Forms\Misc Bldg Permit App