HomeMy WebLinkAboutApplicationGarlield Cor-trtt>z
108 8'h Street, Suite 401, GlenwoodSprings, CO 81601
Ph:970-945-82 t 2 Fx:970-384-3440 Inspection Line:888-868-5306
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BUILDING PERMIT APPLICATION
Ut
t STAFF ONI,Y
Lot No: Block No: Subd./ ExemPtion:I Parcel No: (this informatnn is avarlable al the assessors ofiice 970-9'15-91 3"1)
1917-274-00-012
2 JobAddress: (rfunatldresshusnotbeenassigned,pleaseprovitleCl?,HWorStreetNume&City)orandlegaldescription
SESE Sec 28, T4S, R96W P28 496 Man Camp
AIt PhPh:
s70-285-2656Mailins Address:
2717 cR 215 Parachute. CO 81635Owner, Qtr ope r ty ow ne r)
Encana Oil & Gas (USA) lnc
J
Ph:
970-858-8859
AIt Ph:Mailing Address: 864 20 Rd
Fruita, CO 81521
4 Contractor:
Mtn West Oilfield Services
Lic #Ph:Mailing Address:5 Manufactured home installer:
AIt Ph:Ph:Mailing Address:Architect:6
Ph: 970-928-8536 AIt Ph:Mailing Address: 715 Grand Avenue
Glenwood Springs, CO 81601
7 Engineer:
MPA Consulting Engineers
Height:No. of Floors: 2Sq. Ft. or Acres of Lot: 2.g acre well pad8Sq. Ft. ofBuilding, 3360
ONew EAlteration EAddition ERepair DDemo EMoue
Class of Work:9 Use of Building
KotherDResidential
l0 Describe Work: lnstallation of manufactured buildings for a Man Camp on drilling location
fNat. Gas EPropane EElectric Eother
Type ofHeat:
6ISDS Ecommunity
SepticllGarage:
OAttached EDetached
Owners valuation of Work:Driveway Permit: N/At2
letter ofauthority, signed by the Owner, must be provided with this Application.
Lesal Access. A Building Pemii camot be issued without proof of legal md adequate access to the property for purposes of inspections by the Building Department.
County Highway/ Road Access or a State Wastewater Dischuge Pemit.
days after commencement
.ERTIFICATI'N
md spicifications md other data submitted by me or on my behalf(submittals), based upon my ceflification as to accuracy.
the submitta.ls reviewed by the Building Department.
construction oiuse oftho structure(s) md facility(ies), described above, ue not in complimce with County Regulation(s) or any other applicabte law.
of Comty Regulation(s) or my other applicable law
limitation my architect designer, mgineer md/ or builder.
I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE NOTICE & CERTIFICATION ABOVE:
DATEATURE
NOTICE
August 1 1, 201 1
Special Conditions:
Misc Fees:Manu home Fee:
6m- oo
Plan Check Fee
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Permit Fee
99s. z tAdjusted Valuation:
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ISDS No & Issued Date
:,rpl-Aa33
BP No & Issue Date:
ztSq
Balance Due:/o53./6Total Fees:t/s3.te Paid EDFees
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Zoning:
(lOCC Group RZ ConstType:
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Setbacks:
DATEALDATEAL
Decrlpdon of Wort: Manufacttrrcd buildirgs br man camp at drillirqg locatbn
Bln #:
Locatiotr Addrcss:
PARACHUTE CO
Building Plan Review
Cerc Mrnegcr: David Bartholomerr
Plrn CrsG Nunbcn BLDG-& 114961-
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Applicatior Deb: 0Ul20l I
Owncn EnCans Oil aDd Cras
Applhrnt: EnCanaOil md Gas
Appllcant Phone 7m'87&351 3 Emait bob.vreve@€ncana
( )orttitct:;(lent:r ;rl lrttor tritltott
Buildins
Driveway Permit
Surveyed Site Plan
Permit and Setbacks
Fire Department Review
Determination/Fees
Conditions
Signed
Reviewer To Sign Application
No.
40# Snowload Letter - Manu Homes
// erade/Topog nphy 10o/o
/Planning lssues
/
----#ubdivision Plat
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/ Engineered Foundation J*roperty Line setbacks
,/
,/ erade/Topography 30%
,/n--o*ch Residentiat Plan Review List//
Stream Setbacks
Plain
height
Signoff
lmpact Fees
Approval
,/
Line PlanslstampslEticker General
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oo-oo/t*//.n/Qailc Report
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NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Officialthat additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The building department will collect a Plan Review fee at time of application submittal. The Permit Fee,
as well as any Septic or Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by a person having written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of this
checklist.
e
sig of Owner Date
Garfield County Building & Planning
108 8th Street, Suite 401
Glenwood Springs, CO 81601
Phone: 970-945-82 12 Fax: 970-384-3470
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