HomeMy WebLinkAboutApplicationPlan ('heck Fee:
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Gtzr-y`i eZd G'o un t 1
108 8J' Street, Suite. 40!, Glemvood Springs, CO 81601
Ph:970-945-8212 Fx 9.70-384-3440 inspection Line 888-868-53116
awry eartield-couny.com
BUILDING, PERMIT APPLICATION
Parcel No' (trine rnfurmurr.m o available u1 the assrs.rurx office 971/.945. viv,i)
ct2 1 7 l- - ;-.1 ,I 1-c() C'
2 r Job Address; (e,1. ern urddrrr.v teens rent hien,ssatgrwti, pteurr provute l'It !AI'1- or Sired Minty d iy) in and legal description
*.Se 04 A lot _t dtr, 4ir,
3 Owner:
(propcnvtn. nrr)/ Mailing Address. Ph;
CI sue. .S1 e, (co,,,.. tLC PC. lice (0`a(=(-,flr CO Mil. , (?7L') �C-S-S3c
4 Cont or: i Mailing Address ' Ph:
Pc,:c, 22,.)., -C. -.7...,, -moi `-l(�eJ f' C.K. F (r..i:cr CD MS PIS\"")Fol-liSI
5 '-Manufactured home insLtller: Mailing Address Pit
Lot No:
Block No: Subd./ Exemption'
Architect.
8
10
II
12
lingineer:
Mailing Addre s:
Mailing Address;
Sq Flor Building Sq. Ft. or Acres of Lot.
'JCS 3D -i ,22 At.r •,
Use of Building' Class of Work:
❑Residential UCutmnereial ❑Other SNcw ❑Alteration ❑Addition Dile air ❑Dern ❑Move
Describe Work: r + ! , c.pr
!O''' IO ,,..r«_h�r,ida. (:s so.i.,(`tci , . 're iV1A.,„ie,JvrrA I.,., I‘.j;... t r-.ke( k;f
Garage: 1 14 Septic- Type of I lead r
❑Attached ❑Detached ❑ISDS ❑Community -e - ❑Nal. Gas ❑Propane ❑Electric ❑Other
Ph:
Ph:
1{eigth+. rI
Alt Ph'
Alt Ph:
l is P.
Alt Pir
Alt Ph.
No. of Floors'
Driveway Permit: Owners i.aluation of Work; ; e
NOTICE.
Authority. Trus application for a Building Permit trust be signed by the Owner of the property, described above or an authorized agent if the signature below r. not that of the Owner, a separate
letter of authority. slimed by the Owner, moil be provided with this Application
Legal Access, A Building Perms cannot be tinted wdhout proof of legal and adequate access to the property for purposes of rnspecnons by the 13uildmu (Department
Ocher Permits, Multiple separate permit+ may be required. i I State Ltectncal Permit ;2) County ISDS Permit, (3) another permit required for use on the property identttied above est State or
County Highway-. Road •keens ora Stale Wastewater Discharge Perms.
Void Permit, A Budding Pemttl becomes null and void if the work authonxed us not commenced within ' SO days of the date of issuance and if work t:. suspended or abandoned for a penod of 180
days after commencement
CERTIFICATION
1 hereby certify that Hone read lit u Application and dam the information contained abo+•e is tnie and coned. 1 understand that the Building Department accepts the .Application, Wrong write the plans
and specifications and other data submitted by Inc or on my behalf (submittals), based upon my certification as to accuracy
Assuming completeness of the submittals and approval cf this Application, a Budding Permit well he issued granting permission to mc, as Owner to construct the structure' s) and facilites derailed on
the submittals reviewed b) the Budding Dcpanincni
In consideration oldie issuance ail= Budding Permit. I agree that I and my agents will comply with provisions of any federal irate or local law regulating the work at the Garfield County Building
('ode, ISDS regulations and applicable land use mutilations (County Regulation(sli I acknowledge that the Building Permit may be suspended or revoked, upon nonce lmm the County. rfthe location
cnnslrucriun or use of the structure's) and fa;ilitytiei) described above air nal in compliance with ( minty Rcsulaton(s) or any other applicable law
I hereby grant pemusann to dm Building Depannicnt to enter the property. drscnbed above to inspect the work i further acknowledge that the issuance oldie Budding Puma dues not prevent the
Building Official hum 111 requ mg the correction of error, in •ate submittals. of any dt,wivered after issuance; or (2) snipping construction or use of the structures) or facdryt.c) if such is in violation
of Courtly Resulationf s) or any other applicable law
Review alibis Application. Mt:hiding submittal!, and mspecnans of the wank by the Building Department do not cumsurmte an acceptance of respunsIhdii) or liability by a County of errors omissions
or discrepancies. As the Owner i adenc.wtedgr that respoeaandny fur cumphancc with federal stale and local laws and County Regulations rest with tar and my authorized agents including without
limitation any arcbucct designer engineer and- nr budderIL.,.:)_."`)
\
n I lii:ltf F {t' ACLNOWLLD(1 Ti 1AT 1 IDAVE READ AND LNDERSfANDTI f NOTICE & CERTIFICATION ABOVE �3, c�
l �
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OW,A ws S1C}i'I `r illRE j14 }
i1g1 kG 131•
%pecial Conditions:
d Valuation:
..0Q
Fees Paid:
2 .91
100
-shzi I I
D1 F
STAFF USE ONLY
Permit Fee:
r zs
Balance Due:
/. /,S
OCC Croup
Ft
Manu home Fee:
Const Type:
brise Fees:
INDS No & Issued Date:
Zoning:
L
/15
A PROVAL DATE /
Building Plan Review
Description of Work: Pump building, assembled from a pre -manufactured building panel k
Bin #:
Location Address: 22539 Hwy 6 and 24
RIFLE, CO 81650
General Information
rCase Manager: David Bartholomew
Plan Case Number: BLDG -4-1 1-6803
Parcel: 217521100022
Application Date: 04/0612011
Contacts
Owner. Clough Sheep Company, LLC
Applicant: Clough Sheep Company, LLC
Applicant Phone: 970-618-7631 Emit
Building
Planning/Zoning
Engineered Foundation / Property Line Setbacks
Driveway Permit ter:. 30ft Stream Setbacks
Surveyed Site Plan " Flood Plain
Septic Permit and Setbacks Building height
Grade/Topography 30% _ 7oning Sign -off
Attach Residential Plan Review List
totil
—7—Subdivision Plat Notes GradelTopography 40%
Planning issues
%V _,/ oad Impact Fees
Minimum Application Questionnare N! 4,HOA/DRC Approval
04- Fire Department Review
Valuation Determination/Fees
—Fed Line Plans/Stamps/Sticker
{ Attach Conditions
pplication Signed
Plan Reviewer To Sign Application
arcel/Schedule No.
40# Snowload Letter - Manu. Homes
y" Soils Report
Subdivision Plat
General Comments:
U, / ,rb 1,0a .aa
Fermtt 49e 181. ZS'
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