HomeMy WebLinkAboutpitkin.eh.264903200002 (1996) Fireplace RegistrationAspen/Pitkin Environmental Health Department
Fireplace/Woodstove Permit
Parcel ID # of Property (avail4ble from Assessor, 920-5160) -2%�I0 3a.0000,),
Name of Owner of Property 14 nd exr s- C harlerw fforn,
Owner's Mailing Address R0 ox 51 Good 8') W,
Street Address of Property D3,7 C, X 1(423
Legal Description of Property 44, ! e�on 3 , —►ownsh',p q S%A,2!Ma 89 &s
Owner's Phone N umber Ra3- 6 S 35
Structure Type: Single Family 0 Duplex ❑ Condo/Townhouse ❑
Apartment ❑ Commercial ❑ Other ❑
♦ If this is new construction (not a remodel or addition):
Type of device # you plan
to install room
If this is a remodel or addition to an existing structure:
For the fireplaces/woodstoves you already have:
what devices will you be adding?
Twe of device # added room
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Signature of Applicant/? fk- D- e 94 Receipt i
Envir Health Dept Approval —WL� c— Date / � �� K- Date Paid
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