HomeMy WebLinkAboutApplication- PermitGarfield County
Building & Sanitation Department
108 8``' Street, Suite #201 Glenwood Springs, Co. 81601
Office- 945-8212 Inspection Line- 384-5003
Job Address
NO. 93(09
o v6/0 gotoeSd7F.
/4/l 4
Nature of Work Building Per it
Use of Building
Owner
Contractor
/7/1 c_io
(ii c)
t
Amount of Permit $ // 96:151,
Date
Clerk
��-,30 -OE/
GARFIELD COUNTY BUILDING PERMIT APPLICATION
108 8`a Street, Suite 201, Glenwood Springs, CO 81601
Phone: 970-9454212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003 3 Z.7 7
Parcel/ScheduleNo: k0. C/ /O3Z `09)77 -333c0
Permit No: — l t xcc9)
AGREEMENT
PERMISSION 1S HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT
THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT.
IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28201 CRS A5 AMENDED. THE SIGNER FURTHER AGREES THAT
IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED
STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE R SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER
REQUIRING THE CORRECTION OF ERRORS IN SAID PIANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING OPERATION BEING
CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION.
THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF
ANY RESPONSIBILITIES OR LLABLITIFS BY GARFIELD COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS
AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE
INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST.
Garfon.003 ,t DY A ENO E T I HA UNDERSTAND THE AGREEMENT ABOVE (INITIAL): i
Ci1/44 11-3b7 r 4 as" THAT t 1�Y
Job Address:
19 96 6 frkrZi /it Aka d -tycc, I+ - -eg , £� rO
1 Lot No: Block No:
'NF1 Ser44wwelta 3.3 -to -94 hese flew& ilt
Subd. / Exemptiion:
inMAL reanekc
2
Owner: WasjaIt. jtriwi.-f-A-
B)I ye JP 4
Address !� V441 -V441- Co.
e 46 6 aa,lis w 41(414.
Ph:
(OLS- Aso t.
Wk Ph:
3
Contractor:
le S
Address: ,evc(�
/ Drag &terraCdt
Ph: RS «f CO PI b5
IPLS%V707
Lic. No.
4
Architect/Engineer:
Address:
Ph:
Lie. No.
5
Sq. FL of Building:
Sq. Ft. of Lot.
Height:
No. of Floors:
6
Use of Building: •
#88atfe Dwo-1lit, (zR(
7
Describe Work:
Claw spare ~ !Mod u(6r
8
Class of Work: e— ew o Alteration o Remove
o Addition o Move
9
10
Garage: ❑ Single
lY o Double
Carport: o Single
❑ Double
o Driveway Permit-, ya5S a On -Site Sewage Disposal o Site Plan
1j10 I6V0.te kb.d NfeSA (Septic)
11
I
Valuatiod of Work: $tisane)
Adjusted Valuations: $ 4 ga
12
c(6.kdife0
I:�,
/I�
Special Conditions:sR5+'a /( )42uJ V41Cdv fax Sic 419'/4 half Cu r fh. 'apes 141
4 be ✓,ew4.etre.d
.-lam *-q d�'1. Qw STic 7m.c r 4- Fiat-FOC/am
�Tt
A SEPARATE ELECTRICAL PERMIT IS REQUIRED
ISSUED BY THE STATE OR COLORADO.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR
AUTHORIZED 1S NOT COMMENCED WITHIN 180 DAYS,
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
PERIOD OF 180 DAYS AT ANY TIME AFTER WORK I5 COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND
APPLICATION AND KNOW THE SAME TO BE TRUE AND
PROVISIONS OF LAWS GOVERNING THIS TYPE OF WORK
COMPLETED WITHIN WHETHER SPECIFIED HEREIN
GRANTING OF A PERMIT DOES NOT PRESUME TO
TO VIOLATE OR CANCEL THE PROVISIONS OF ANY
LOC L LAW REGULATING CONSTRUCTION OR THE
O'.�a' 1NSFRUCTION. c.,
AND MUST DE
CONSTRUCTION
OR IF
FOR A
EXAMINED TRIS
CORRECT. ALL
WILL BE
OR NOT. THE
GIVE AUTHORITY
OTHER STATE OR
PERFORMANCE
Q•
Plan Check Fee:
_.7
2'S'g.��
Permit Fee:
341 i. Z�
Total Fee: lay Dated Permit Issue
S s b f /SO•d9 lin
l'0 1
40475 JO5
Sr
OCC Group: Const. Type:
Zoning:
Setbacks:
Manu. Home: ISDS No.& Bee:
150. crLD
400.E "-`El �J
/ Tie , 1,0
a ,
.
TI} •ER ;
•Acn 8 �2_ �a��l:
B E" LN f'.
teit•
APPR1 . /DATE r�
AGREEMENT
PERMISSION 1S HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT
THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT.
IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28201 CRS A5 AMENDED. THE SIGNER FURTHER AGREES THAT
IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED
STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE R SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER
REQUIRING THE CORRECTION OF ERRORS IN SAID PIANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING OPERATION BEING
CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION.
THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF
ANY RESPONSIBILITIES OR LLABLITIFS BY GARFIELD COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS
AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE
INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST.
Garfon.003 ,t DY A ENO E T I HA UNDERSTAND THE AGREEMENT ABOVE (INITIAL): i
Ci1/44 11-3b7 r 4 as" THAT t 1�Y
0/Ki
FEE FST/MATS
FINISHED LIVING SPACE:
UNFINISHED BASEMENT:
CRAWL SPACE: 3165 X 9.00 =
X74.68=
X 41.00 =
GARAGE: X 18.00 =
UNCOVERED PATIO/DECK: X 12.00 =
COVERED PATO/DECK: X 24.00 =
MISC.
MISC.
TOTAL VALUATION:
PLAN REVIEW FEE: 0.64 3/
PERMIT FEE:
TOTAL:
S
:,.
7
MANUFACTURED HOME SET UP FEE: 1(CD ,
SEPTIC - PERMIT:
PERK: I CR) .vim
GARFIELD COUNTY BUILDING AND PLANNING
970-945-8212
MINIMUM APPLICATION REQUIREMENTS
For
MANUFACTURED HOMES
In order to understand the scope of the work intended under a permit application and expedite the issuance of
a permit it is important that complete information be provided. When reviewing a plan and it's discovered
that required information has not been provided by the applicant, this will result in the delay of the permit
issuance and in proceeding with building construction. The owner or contractor shall be required to provide
this information before the plan review can proceed. Other plans that are in line for review may be given
attention before the new information may be reviewed after it has been provided to the Building Department.
Please review this document to determine if you have enough information to design your project and
provide adequate information to facilitate a plan review. Also, please consider using a design
professional for assistance in your design and a construction professional for construction of your
project.
To provide for a more understandable plan in order to determine compliance with the building, plumbing and
mechanical codes, applicants are requested to review the following checklist prior to and during design.
Applicants are required to indicate appropriately and to submit the completed checklist at time of application
for a permit. Applicants are required to indicate appropriately and to submit the completed checklist at the
time of application submittal for a permit.
All plans submitted must be incompliance with the 2003 IRC for Residences and 2003 IBC for
Commercial Offices and Storage.
1
1. Is a site plan included that identifies the location of the proposed structure or addition and distances to
the property lines from each comer of the proposed structure prepared by a licensed surveyor and has
the surveyors signature and professional stamp on the drawing? Properties with slopes of 30% or more
must be shown on site plan. (NOTE Section 106.2) Any site plan for the placement of any portion of
a structure within 50 ft. of a property line and not within a previously surveyed building envelope on a
subdivision final plat shall be prepared by a licensed surveyor and have the surveyor's signature and
professional stamp on the drawing. Any structure to be built within a building envelope of a lot
shown on a recorded subdivision plat shall include a copy of the building envelope as it is shown on
the final plat with the proposed structure located within the envelope.
Yes
2. Does the site plan when applicable include the location of the I.S.D.S. (Individual Sewage
Disposal System) and the distances to the property lines, wells (on subject property and adjacent
properties), streams or water courses? This information must be certified by a licensed surveyor
with their signature and professional stamp on the design.
Yes
3. Does the site plan include any other buildings, setback easements and utility easements? Please
refer to Section 5.05.03 in the Garfield County Zoning Resolution if the property you are applying
for a building permit on is located on a comer lot. Special setbacks do apply.
Yes l
4. Does the site plan indicate the location and direction of the County or private road accessing the
property?
Yes i
5. Do the plans include a foundation plan indicating the size, location and spacing of all reinforcing steel
in accordance with the uniform building code or per stamped engineered design? A Floor Plan of the
Modular Unit showing exterior doors is required.
Yes /
6. Do you understand that if you belong to a homeowners association, it is your responsibility to obtain
written permission from the association, if required by that association, prior to submitting an
application for a building permit? The building permit application will not be accepted without it.
Yes / No
7. Will this be the only residential structure on the parcel?
Yes No If no -Explain:
8. Have two (2) complete sets of construction drawings been submitted with the application?
Yes /
2
9. For the placement of a manufactured home, have the following been specified?
The size of the unit (min. 20ft. x 20ft.); live roof load (min. 40# could be more depending on elevation
of property); wind design (min. wind speed of 90 mph); foundation design; method of anchoring?
Yes /
10. Have you designed or had this plan designed while considering building and other construction code
requirements?
Yes No
11. Do your plans comply with all zoning rules and regulations in the County related to your zone district?
Yes / No
12. Does the plan accurately indicate what you intend to construct and what will receive a final inspection
by the Garfield County Building Department?
Yes / No
13. Do you understand that approval for design and/or construction changes are required prior to the
application of these changes?
Yes / No
14. Do you understand that the Building Department will collect a "Plan Review" fee from you at the time
of application and that you will be required to pay the "Permit Fee" as well as any "Road Impact" or
"Septic System" fees required, at the time you pick up your building permit?
Yes i No
15. Are you aware that you must call in for an inspection by 3:30 the business day before the
requested inspection in order to receive it the following business day? Inspections will be made
between 7:30 a.m. and 3:30 p.m. Monday through Friday. Inspections are to be called in to 384-
5003.
Yes No
16. Are you aware that requesting inspections on work that is not ready or not accessible will result in a
547.00 re -inspection fee?
Yes No
17. Are you aware that you are required to call for all inspections required under the IRC including
approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy of the
building?
Yes No
3
18. Are you aware as part of the submittal for a building permit you are required to show proof of a
driveway access permit from Garfield County Road & Bridge Department or if applicable the State
Highway Department? If a permit is not necessary, then a letter stating that information is required.
You can contact the Garfield County Road & Bridge Department at 625-8601 or refer to the phone
book for the State Highway Departments number if applicable.
Yes / No
19. Do you understand that you will be required to hire a State of Colorado Licensed Electrician and
Plumber to perform installations and hookups, unless you as the homeowner are performing the work?
The license number of the erson performing the work will be required at time of applicable
inspection. Yes No
20. Are you aware, that on the front of the Building Permit Application you will need to fill in the
ParcellSchedule Number for the lot you are applying for this permit on prior to the submittal of a
building permit application? Your attention in this is appreciated.
Yes r No
21. Are you aware that you will need to have your installer obtain an installation inspection as per the
State Division of Housing requirements prior to the County building department doing their final
inspection? The State will charge a fee for this inspection.
Yes — No
22. Are you aware that the Permit Application must be signed by the Owner or a written authority being
given for an Agent and that the party responsible for the project must comply with the Uniform
Building Code?
Yes — No
23. Are you aware, that if you receive your water and/or sewer from an Association, a District or
Municipality, you will be required to provide the County with a copy of the Tap Permit (or evidence
of an exemption) at the time of the building permit application submittal?
Yes No
4
I
I hereby acknowledge that I have read, understand and answered these questions to the best of my
ability.
("Ft
Si afore of Owner
Phone: (S/ ZS Si 7 0 '7 (days);
Project Name:
` �� ah/J wv� �-
Project Address: m V 2 �,{/ � % .1� �� ��
7 (evenings)
Notes:
If you have answered "No" on any of the questions, you may be required to provide this information at the
request of the Building Official prior to beginning the plan review process. Delays in issuing the permit are to
be expected. Work may not proceed without the issuance of a permit. If it is determined by the Building
Official that additional information is necessary to review the application and plans to determine minimum
compliance with the adopted codes, the application may be placed behind more recent applications for
building permits in the review process and not reviewed until required information has been provided and the
application rotates again to first position for review, delay in issuance of the permit or delay in proceeding
with construction.
bpminregmhOct2004
5
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Dee 013 2004 4:39 FBC#II#ttaattattltanatttt 9706253502 p. 1
11/22/2004 15:12 3076025062 PAGE 01
i
CHIEF MAME /C.. HILWGOD ION
00. Box 127
111 Brant $t
Aurora, Nabaska 60016-0127
Rhone 402-694-5250
November 18, 2004
Liechty Homes, Inc.
1300 East Hwy 14 & 16
Exit 128 I-90
Gillette, WY. 82717-1327
Re: BonneVilla® Modular
Floor Flat: 976MAA-04
Customer. BRENNEN
Dear Sire :
This letter is to identify the design criteria of the above modular home. The
following Code references will be used in the construction of this horse:
2003 IRC
2003 IECC
2002 NEC
2003 IBC
2003 IMC
2003 IFC
As for the specific design criteria itself, the following minimums shall be established
for this borne:
Floor live load:
Roof live Toad:
Wind loading:
Seismic Zone:
Roof Pitch:
40 paf LL
40psfLL
100 mph, Exposure 'C (3 sec. gust)
D1
2.512
/��/ PLAN REVIEW CHECKLIST
Applicant f✓grasboy Date /2 -41' 7.oc/
Building
a. /engineered Foundation
i((.4.Driveway Permit
✓Su,'eyed Site Plan 7 SO
✓Septic Permit and Setbacks
✓Gr�ade/Topography 30%
✓Attach Residential Plan Review List
inimum Application Questionnaire
it. / Subdivision Plat Notes
414. Fir Department Review
Valuation Determination/Fees
✓ Red Line Plans/Stamps/Sticker
,-Attach Conditions
--K plication Signed
✓ Plan Reviewer To Sign Application
/Xi-cel/Schedule No.
LZ; -1.# Snowload Letter- Man£ Hms.
GENERAL NOTES:
Planning/Zoning
Property Line Setbacks
30f1 Stream Setbacks
Flood Plain
Building Height
Zoning Sign -off
Road Impact Fees
HOA/DRC Approval
Grade/Topography 40%
Planning Issues
Subdivision Plat Notes
11/15/2004 17:12 1076025352
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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit 102-8
Assessor's Parcel No.
This does not constitute
a building or use permit.
�j / y�'} .Iy��L
Owner's NaStP IWYl \RCCA l.}1 -i `pnment AddreTss\� 'tir / (�l.l)}}fl n/tl ! !• L} phory ( ?
System Location rel / r- f r r rb \p on rf 1 I . 1,14 Ln25- - (-1 c 1
Legal Description of Assessor's Parcel No. nWIE- ,2/ �- -3-3? -
SYSTEM DESIGN
12-S-0 Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
r1/110 /�'a._ c,
(Y . S ) i t ^Stix ---Ill
i''
JJ '
Inspector /' i�•G t,�"L L� —/ I(—P w l
Required Absorption Area - See Attached
Special Setback Requirements:
Date
/
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer C <;
Septic Tank Capacity a j 0
a
Septic Tank Manufacturer or Trade Name 1 1-1 /- • u
Septic Tank Access within 8" of surface ' (.5L,
tJ
Absorption Area•'
/-7
Absorption Area Type anWor Manufacturer or Trade Name
k✓ .
Adequate compliance with County and State regulationslrequirements
Other
1.e A --
Inspector ' ;It
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
25. Article 10 C.R.S. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a
requirement of the permit and cause for both legal action and revocation of the permit
3. Any person who constructs,alters. or installs an individual sewage disposal system In a manner which involves a knowing and material
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (5500.00 fine — 6
No •936,9
Job Address
Owner
Contractor TC
Assessor's Parcel Nos 111 'V Y&2
Date /• an
one #1,7--rr3��-;;L
e c'
BUILDING PERMIT A D
_ • it
MSetbaf
Soils Test
Footing
Foundation ( 2/-o.
Grout
Underground Plumbing
Rough Plumbing 3 3 OSa
Framing
Insulation
Roofing
Drywall
Gas Piping 3-flsi "k-
0
Front Rear
e5nC54 rQC) INSPECTIONS
Address
AddressarRSCAb.tCISO CI
LH
RH
trm
tefriegOttaag41
as 3° q
EXTERIOR
Address No.
Drainage
Decks -support & clearance to wood
Decks -stairs 8 rails
Exterior locks
r✓
Flashing around doors A windows
Insect screens
INTERIOR
GARAGE
Fire wall separation
c+i1-
Service doors-13/4min
Door (20 min.) w/auto closer -1i mm
Mech. equip. 18" above floor
No opening into sleeping area
BASEMENT -CRAWL AREA
Access ✓
Insulation ✓
Headroom/Stairs
Ventilation
Zoning
#/17� 1/
Weatherproofing
Mechanical
Electrical Rough (State)
Electrical Final (State) a%281:19-5 [�
Final, 23 Qh#\JChecklist Completed" r --V
Certificate Occupancy #
Date .
Septic System #
Date
Final ,i,-
Asko
they
NOTES r�r[.�s'77c�9ti- CEL-
T ` C'�(continue on back)
�ct,»tL
FINAL CHECKLIST
MECHANICAL ROOM
Boiler
Hot water �1
F.0.—
Floor dram
Clearance
Air con. system / —
Hot water heater
Combustion air
Gas piping, valves
LPG Drain
FIREPLACE/STOVE
Clearance to combustibles
Termination of chimney
Combustion air
Hearth (12" or 20" on sides)
Glass doors
Certified by;
STAIRWAYS
Headroom (8'8"), w M] e
Railing 8 guardrails
Width
Rise 8 run
KITCHEN
Clearance above grill
Exhaust fan
Broiler exhaust (1 hr. chase)
BEDROOMS
Egress
/Smoke detector '✓
it/Smoke
BATHROOMS
✓ Exhaust fan
Shatterproof glass
✓ OTHER
REMARKS
INSPECTIONS WILL NOT BE MADE UNLESS THIS CARD IS
POSTED ON THE JOB
24 HOURS NOTICE REQUIRED FOR ALL INSPECTIONS
MANUFACTURED HOME
BUILDING PERMIT
JJ GARFIELD COUNTY, COLORADO CrDate Issued/�j ..Zoned Area Permit No f 3107
AGREEMENT
In consideration of the issuance of this permit the applicant hereby agrees to comply with all laws and
regulations related to zoning, location, construction and erection of the proposed structure for which
this permit is granted, and further agrees that if the above said regulations are not fully complied with
in the zoning, location, erection and construction of the above described structure, the permit may
then be revoked by notice from the County Building Official and IMMEDIATELY BECOMES NULL
AND VOID.
Use (\k iL rs C - _
Address or Legal DescriptionO 66 ,4"�yaLL ` f (�
Ownerr� re. G W' 4 -T. -Contractor —1£. S
INSP CTION RECORD
Footing:
/—/Blocking/`
Foundation or Blocking : 0.Ow\priveway
Rough Plumbing : 3-3-05 itht4--
Gas Piping : 3_3_Z
Electrical Final: 1 .20 5 /
(by State Inspector) iso
n y�
Septic Final p5 : ^ 9 i' /Q [�1
-
-
Final : 3/�S/QS
.4�"A�.:.t /92-7
Notes: // !
'7 Soowload ° lbs
uPr
!a-1
,,,, n�
-a—.
)
'/ A�J 7
Serial Si of Unit: 65-1-30 9'q6 (L�
THIS PERMIT IS NOT TRANSFERABLE
Phone 384-5003 108 8th Street, Suite 201. County Courthouse Plaza Glenwood Springs,Colorado
DO NOT DESTROY THIS CARD
APPROVEDJ
Date ica 36.-011
„.-0 T
B
(IF PLACED OUTSIDE, COVER WITH CLEAR PLASTIC)