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970-10-5501Phoner
81623
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309-4504R&J Enterprises lnc
P.o. box 236 carbondale co 81623
970
EûiailAddre5Èj;Jg utterspanels@gmai l.com
Mailine Address:
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'Eñiiiäèer: - , Phone:
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'EmallAddress:
Manufactured Home lnstaller:F,hgnei ft
es, dry in roof with new ice and water shield
On entire roof deck, and install new tamko titan xt shingles
14116118 primrose lane carbondale co.81623
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Assessoy's Parcel N umb.er, t
ownefs.Valùatiôo of l¡{ork:Property Sire (Sq. Ft, or $c¡esf: '. _
of Floo¡si.-
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I hereby 'that I have read and understand the Notice and Certifícation above, as cuell as, have
provided the requirèil i nformãtion which ls coÍrect and acçr¡iate to the best Sf my knowledge.
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SiHned Approval
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Date