HomeMy WebLinkAboutApplication.pdfREC~ JUL ~ Garfield County GARFIELD CCQINiIi'6nity Development Department )MMUNITY DEVELOPME~il8 8th Street, Suite 401 Glenwood Springs, CO 81601 1970) 945-8212 www.garfield-county.com
TYPE OF CONSTRUCTION D Com merci al/Multi-Family D Residential (SF, Duplex, or Townhome) D Manufactured Home (SF or Duplex) INVOLVED PARTIES D Demolition 0 Reroof Iil Grading (locale
all ulililies prior 10 grading) Property Owner: Parachute Battlement Mesa Park & Rec District Phone: (970 ) 285-0388 Land Owner: Garfield County School District No. 15 --Mailing Address:
259 Cardinal Way (mailing: PO Box 299) Parachute, CO 81635 ~ Il'l\d.~ Contractor: TBD Phone: ( _ ) Mailing Address: Landscape C t 0 Architect: onnec ne Phone: (970 ) 618-3324 Mailing
Address: 435 N. 8th St., Carbondale, CO 81623 Engineer: SGM Phone: (970 ) 945-1004 Mailing Address: 118 W. 6th Street, Suite 200 Manufactured Home Installer: Phone: ( _ ) Mailing Address:
PROJECT NAME AND LOCATION Describe Work: Grading, utility, road construction Job Address: Sipprelle Dr. , Battlement Mesa Assessor's Parcel Number: Unplatted 333476? Sub. Battlement
Mesa PUD Lot Block 140 7081ro IS2. --Owner's Valuation of Work: Property Size (Sq.Ft or Acres): 6.15 acres Sq.Ft of Building: Height: # of Floors: Class of Work: o New I 0 Alteration
10 Addition o Repair I 0 Move/Relocation Garage: o Attached o Detached Septic: o ISDS • Community Type of Heat: o Natural Gas I 0 Propane I 0 Electric I 0 Other Driveway Permit: o Exempt
o Permit#: Grading Square Feet of Earthwork 348.480 Cubic Yards of Earthwork 17.000
NOTICE Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the
Owner, a separate letter of authority, signed by the Owner, must be provided with this Application. l egal Access. A Building Permit cannot be issued without proof of legal and adequate
access to the property for purposes of inspections by the Building Division. Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County 1505 Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/Road Access or a State Wastewater Discharge Permit. Void Permit. A Building Permit
becomes null and void jf the work authorized is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION I hereby certify that I have read this Application and that the information conta ined above is true and correct. I understand that the Building Division accepts the Application,
along with the plans and specifica tions and other data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness of the submitta
ls and approval of this Application, a Building Permit will be issued granting permission to me, as Owner, to construct th e stru cture{s) and facilities detailed on the submitta ls
reviewed by the Building Division. In consideration of the issuance of the Building Permit, I agree that I and my agents will comply with provisions of any federal, state or local law
regulating the work and the Garfield County Building Code, 1505 regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit may be
suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s)
or any other applicable law. I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I further acknowledge that the issuance of
the Building Permit does not prevent the Building Officia l from: (1) requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction
or use of the structure(s) or facility(ie s) if such is in violation of County Regulation{s) or any other applicable law. Review of this Application, including submittals, and inspections
of the work by the Bui lding Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner, I acknowledge
that re sponsibility for compliance with federa l, state and loca l laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer,
engineer and/or builder. I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provided thyeq~rmation which is correct and accurate
to the best of my knowledge. Dr K~bD ~iJ/?J:; J I ) Property Owner Print and Sign Da e OFFICIAL USE ONLY -'l' fI Special Conditions: al617~ To )<:Li;JC...>IT S'l<Jlittr 'FRc./I{ ~~ +-hDi..
/t) CbUSfP, ttr..:rr C kL Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee: Mise Fees: -----1'-100·--------Total Fees: Fees Paid: Bala nce Due: BP No: 1505 No: 400 ylJO
A!f 6rod-~qd,~ Setbacks: OCC Group: Canst Type: ~o1 r-. ~ BUILDING I PLANNING DIVISION : ~ I I \l. ~"L>ZDi3 ~~al""'" Date 't)\' ""f . ~~ ' I)
Pipelille Grading Permit Checklist Project name/operater: ?~~i\.. 7Yr-NI. ~ tl-~. ? ~ rr Project general location: 'OTW\ Project acreage: P t;g.ject.Jeng.tb.a.ruLplpe size: Bond Amount
(must equal acreage x $2500): n 'a'::'~ Weed management plan approved by Veg. Management: YM ~j..L lR:Tf~ Property owners including federal lands with easements: ~.<:.ffpi}(.. DJ$.T
~/~ Engineered sealed plans: ~ ') Plan set to county engineer consultant for review: IJ ( AState storm water permit: Yp:.j Any county road cut permits needed: N.o 0~1.. 1M K\)~ f~,p"')
;")LL ~~ II' 'P~1:. ~ Any land use permits needed based on size or flood plain: L~c..I~-lltS'4 If ~nt+f r,<t..*f]I"o'y Any Corp of Eng. wetland issues: (' H J 14' Original Bond and map
to Treasurer's office: Ii bf: Copy of bond in file: JJ (~ Map to GIS: ~~ Other: Pending items/date: v L -I--e: ~ C/ff~ ~h4 CD~l;~ 9-1l