OWTS Site Evaluation

Property location

Parcel Number *

Subdivision

Lot

General Location

Estes Park area Loveland area Berthoud area Fort Collins area Wellington area Red Feather area Bellvue area

Owner Name *

First Name Last Name

Owner Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Owner Email *

example@example.com

Owner Phone Number *

Area Code Phone Number

Applicant Name *

First Name Last Name

Applicant Email *

example@example.com

Applicant Phone Number

Area Code Phone Number

Are these ready for evaluation now? *

Yes, ready immediately No, within a week No, will call and schedule

If you answered no, please provide additional details on scheduling and contact info if it's different from above.

Payment options

Please note, if you do not want to charge the extra processing fee of $4.65 for processing the online payment, you can print out this application and submit it in person at our 1525 Blue Spruce Drive, Fort Collins location.

Application for in person payments can be found here - http://bit.ly/2zA3MYJ

Service

Site Evaluation $ 154.65

Total $ 0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year