HomeMy WebLinkAboutApplication.pdf09/01/2013 22 :02 9702556108 DIVISION OF WILDLIFE PAGE 03/03 RECEWA SEP 1 ~_G-,a......;:~;f:...i._el_'d_C__o~U. n~ty;.-l GARFIELD COU~IU\tty ~ellelo~nt.oep_"nt )MMUNITY DEVELOPMENT 10811
Stlftt, Suite AM. . GlenWllOd SprlJliS, CO 81601 . (970) 94li·821Z 'IhIW·qrfigld-WuiltY,co!JI r;:~!g;.i;.:,:'7~:: w\\oll ,~. ·--·-·L:~:,~:~~~~:~~-;~;~l I MailintAddms:. 71l IoAfpc"dllJ-&n&
&M+ilvr1S'kal\.~O ({{SuS-. I I' Contradftr: AIM D~:d:-~oh~ """CC·'·-··'· Phon";('?7~' ;k;S·s:;;Dj . ~~~.~'-~~~~:.P~~~~. ;.~_: .. _ .,. ~I(+.~ CQ .!'I~:=. @{5-tlJ~+ rel'~ I Architect:.
\oJ/A Phone:! I I I M~U;ng Add,,"! ==.:::===================:..: : ::.:,::..-:,-I . I f"ngIne"J": ~ /"" Pl!.one, ( I , ~ M"lIfng Address: d Manum::d Home Installe" 40 Phone: ( ---I ,
Mailing Address: 1 • I!ROJECTNi\ME AND LOCATlON"---:-_·--:--· -~--:'---'-" -:'---::--:'.-----:-~--~'~~ --.-----................ -.. --......... ~--. ' .-...;....:.---.:-.-~_~_.:.-'....J
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09/01 /2013 22:02 9702555108 DIVISION OF WILDLIFE PAGE 02/03 f:r~· +h~~·a~i~~=n·~~·i·~il~in~·~;~;:·~u~ ~:~;~n~:~~::'~j:Z~~~0;~;i~~~b~l~0:~ : an authoriifflC\agent. If the $lgrIawre bek:1w
Is'not ·that of the OWner, a separate letter of authority, signed by the I I OWn!!l', lI1ust be prOVIded with thIs Application. " I !.gal AcCf!M, "Building Permll .. nnol be Issued without
proof of Itgol and adequal<l access to the prop411y for i pUrOOSe'l of jns~ect!oll'i bv the BuildIng ();v~n. . I ~ Multiple sepamte permits may be required: (1) St:ltc Electrical PRrmlt,
(2) County 15DS Permit, (3) I another permit requlMd for U~ on th<> pI'OpeltV Identified above, e,g. State or county Highway! fIOad Acces:; of a i Statl> Wast ..... ter Discharge Permit.
. • I ; ~l!!l!t. A Building permit be(:ome. null.nd VOid I' the work authorized is Mt eomme~~ wltbilll:l!O'daY5 of I i t/le dDt(' of Issuence and If work Is suspended or abandoned for
• period of 180 dllyS after commencement i !'~!F~1!~:,:·.:.~~L;.::·,.~·~~;~:~T~·~·::~·~ :·-~'~~~:::~L~.:.~;;: ~~.::'~7. :..• ...;: ::,.~.~: ..:~~ ~::::2.:.::·:~~:.~d ! I hlil'eby (Ilrtlfy
that I have read this ApplicatIon and that the informalion' CQnttlined abO\l~ l. true ond eorter.(. I ; j understand Ih'at the 8uadlng OMs/on 8CC/IjItS the Application, alon,gwlth the
plans and spet\ftcalions Rod other I I data submltt~d by fllfI or on my behalf ($uI:l1ll1tt31,), based upon my certlficat10n 11$ to accuracy. Assumln8 I '1' compiorten@$Softhesubm1t!3I$Md.pprOVIII0't
hISApplkalion, 9.Buildillg P~rlT)lt will tie Issued !Venting i . permlsslon 10 me, lIS owner, to tQn,truct the structunr{$) and fatUjtJes detailed on theSllbmittals reviewed by tlJ<l
I ',. Bulldlng DlVkJo.n. In consideration of tbe issuanoo of ille Buildint! Permit) I agl'G:(' th~ I and: mv 'IB'lnl~wlll comptv ; : wIth prD\lisIGns of any federal, slate or local liIw
r.ogulatil18·t/lewOtk and the Garfield Couo1y Building Code, 150S i 'P.gulatlons and applltabkl land u~e l'I!gulatitmS'(County Regulation(.)). I ati<nowledge that the Suildillg Permit
. i I may be sAA~Pflnded Of revoked, upon notice from the County, if the I"""tion, construct!l)n or 0"" o'the .tructo~.) : ,i and faciltty(les), described above, are oot in compliance
with County Regulatlon(s} or any Ilther applicable law. I I hereby gc"nt permission to ths Building Division to enter thE propertY, dewil:l~d above, to Inspect the worl<. I : further
ecknQ\\ll~dge that the issu"nce of the Building Penna ~ nO! prevent the. Building Official from; (1) i requlrlngthe cOfI'ectlon of ~rl'Ors In I!'e 'submltta/S, If any, discovered lifter
Issuance; or (2) stopping canst,uWan i or uS!! of the structure(,) or fadlity(f •• } Ifsur;ll i.ln violatiOn of County RegulatIOn{s) or any other applicable law. I Revit!w of this Applk:a\ion,
il1tludlng .ubml!:t.ls, and Inspections of the work bV Ihe Building DiViSion do no! I, constitute an aw!ptance of responsibility or liability by the CoU/lty of e!ror$, omissions or dlSt)repa"d~$.
As the OWl1er) I acknowledge that responsibility for complian¢<! with federal, .~ate·jlnd locallaw9 and County RIl!lllI:rtlon. , lest wIth me and my authori1.'!d agents, including without
limitation my arthil'\ltt desltlner, engineer MIdI or . iJ>ul@.• .~ . ._ _ .... .... ........ ... . ...... ......... . .. . .. ............ _.. ......_ _.. .... ... .. .........._ .......
.., . ......., ............_ .... ... .... .... . t hereby acknowledge that t have I'f!.ad and understand the Not/te and certification above lIS well ~ hIM! prciv!deIJ the required informatioll
whh:h is COl11lrt ilm:I_rat:eto'thl! best of my ImowI.edae. ~i1~, 9·?·/~ Prope~dSigr\~ Date 1-/8,. '20 13 81.1O.DlNG I PlJINlIlNG DlVlSlON , ...::.~~~~~~i------.,....--Oat.