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HomeMy WebLinkAboutApplication- PermitJob Address Garfield County Building, Sanitation, & Planning Department 108 8`h Street, Suite #201 Glenwood Springs, Co. 81601 Office- 945-8212 Inspection Line- 384-5003 NO. sq 5y - Nature of Work Building Permit - 7 - r. 5 1- - �` 1 Use of Budding akar l.� 10. it e OwnerV fl 1 C ham l l' bbl v` a l\• )3flQr. . Amount of Permit $aR(4-, Contractor Date Clerk ,Lem sum- 2-O°3= r 9 GARFIELD COUNTY BUILDING PERMIT APPLICATION TELEPHONE: (970) 945-8212 • GARFIELD COUNTY (G ENWOOD SPRINGS), COLORADO INSPECTION LINE: (970)384 5003 PARCEL/SCHEDULE NO. 2M S'ZS1.0o-o I 1 PERMIT NO. 7 q EH. TOB ADDRESS: 154 c soirn ROAD 245 , n1 ELw CASTLE , CO I LOT NO. BRACE NO. SUBDIVISION/EXEMPTION 2 o LAS EE PA iwaw ; 4,� "984.2,%14 ""aG8. Sa(o7 3 owr1ER (PD ( 1V.r p "m" .5S5' 4 ell16111116 o wa.1, act. PEE LCNa��r'�j1�S �/' �j �l- ADDY= i gvGne°mo zI 52 sr• c t.Iw 574, iC�ARaCaIi\ �.FT.°� 184,338 14.14 AC- I 11 ?a ., J 1 S$ 6 urnwno gt . 7 of 3sM6tE FAMi% j RBS, a- trick. ELI Ltr °-'B"" NEW Ca•LSl-RUCtlt4 8 MAU OF WORM kaw °¢mor aAlmAm noes °rout 9 ACME nuwn: aww ®ooaa wars ®we 10 anrvn rRrurI J! j4r®.r.,��r. cmm =MtM N I wanwvo.cl{ „SPAM less q'5a al :'.:' iliS • "Rs c2.,CO3 -79:ei �Nv e6 6w " f �&.) a.a 174.4e Ae is :r tt - NOTICE A SEPARATE ELECTRICAL PERMIT IS REQUIRED AND MUST BE LSSUED BY 114E STATE OP COLORADO. THIS HAMM BECOMES NULL AND VOR) IF WORK CE CONSTRUCTION AUTHORIZED E NOT COMMENCED WREN ISO DAYS, COR IF CONS7RUCITON 01 WORK IS EUSYE)QWOEABANDONED POR A PERIOD OF 110 DAYS Al ANY THMm AFTER WORK IS COMMENCED. I HEREBY CLETWY THAT I HAVE READ AND ®(AM DIED THIS APPLICATION AND IINOW TIE SASE TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ODVEUNDIG HIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED°CC: HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTEIORITY TO VIOLATE OR CANCEL 17E PROVISIONS OF ANY OTHER STATE OB. LOCAL - W :.:.. .. 0 ..- V : UCRON OR THE PERFORMANCE OF •'1:N'' .' • V / �� ar . _ t . O ? 1. ., ,.- 1 - -o 3 • PUN CHECK Fa: X3.95 MECO: MI5: 35 TerrAti/a DATE PERMIT ISSUED: 25 S4. 33 ai tP: CONST: TYPE 2- 3 L) - / i' M 77NINC! SMACKS: I °.. di%+. V . Mtn Pler. / AGRB®!RT PERMISSION 15 FEREBY � TO TIM APPLICANT AS CONLRAL'T(E AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT THE STRUCTURE DETABBD ON PLANS AND SPECIFICATIONS SUBMITTED TO REVIEWEDBY THE BUBDBNGDEPARIMENT. • D7 CONSIDERATION. OF TIE ISSUANCE OF THIS PERMIT, TBE SIGNER HY AGREES TO COMELY WTIH AIL BLEEDING CODES AND IAM) USE REGULATIONS ADOPTED GARFIELD COUNTY PURSUANT TO AUITIORITY GWEN IN 30.22101 CBS AS AMENDED. nm STLBNH[ Fora AGUE= THAT IF T1E ABOVE SAID ORDINANCES ARE NOT PVL COMPLIED WITH IN IBE LOCATION, ERECTION, ODNSIRUCLION AND USE OF RHE ABOVE DESCRIBED STRUCTURE, THE PERMIT MAY TEM BE REVOKED BY NOTICE FRI 'DIB COUNTY AND1HATTLEN AND THERE IT SHALL BECOME NULL AND VOID. THE ISSUANCE OF A PERMIT BASED UPON PIANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING T CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS ARID OTTER DATA OR PRO PREVENTING BUILDING OPERATION BEIING CARRIED 0177IEREU NDE1 WHEN VIOLATION MIM S CODE OR ANY OTHER ORDINANCE ORR1GUTATION OF TM JURISDICTION. TIM REVIEW OF THE SUBIBTT&) PLANS AND SPECIFICATIONS AND &18PH.CTRONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF A IIESPONumaIIES OR "saamg; BY GARPIE D COUNTY FOR 1331013, OMISSIONS (R DISCREPANCIES. THE RESPONSIBE.TRY FOR IIESH HESS AND IMPI$.ENIATT I1m3Nt3CONSTRICTION RESTS SPECIFICALLY WDHTHE ARCHITECT, EESIGNER, BUILDER AND OWN13R. COMMENTS ARE INIKNIIEDMBE K�7D P�U4 SUPPO OF THE OWNERS IN73EEn. Gifammoo3 11EREBY AcKNOWLED BTHAT I HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE. W4Ii3AI) —' • The following items are required by Garfield County for a final inspection: • . 1. A final Electrical filspectioh'frotn the'Coforado State ElecfriGasLlnpector, f,. 2. Permanent address assigned by Garfield County Building Department posted where readily 'visible from access road; 3. A finished roof, a lddkabl'e house, complete exterior sidin ,•exterior doors and windows installed, a complete kitchen witli cabinets; sinkwith hot & cold running water, non-absorbent kitchen floor eairerings,, counter tops and finished'wadds, reedy fpr stove and 'refrigerator, all • nece'ssary plumbing; 4. A complete bathroom, with washbowl, tub or shower, toilet stool, hot and cold running water, non-absorbent floors and walls finished and a privacy door; 5. All steps outside or inside over three (3) steps must have handrails, guard rails on balconies or decks over 30" high constructed to all 1991 UBC requirements; 6. Outside grading done to where water will detour away from the building; 7. Exceptions to the outside steps, decks and grading may be made upon the demonstration of extenuating circumstances, i.e. weather, but a Certificate of Occupancy will not be issued until all the required items are completed and a final inspection made. A CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED UNTIL ALL TIE ABOVE ITEMS HAVE BEEN COMPLETED. ****CANNOT OCCUPY OR USE DWELLING UNTIL A CERTIFICATE OF OCCUPANCY (C.O.) IS ISSUED. OCCUPANCY OR USE OF DWELLING WITHOUT A C.O. WILL BE CONSIDERED AN ILLEGAL OCCUPANCY AND MAY BE GROUNDS FOR VACATING PREMISES UNTIL ABOVE CONDITIONS ARE MET. I understand and agree to abide by the above conditions for occupancy, use and the issuance of a Certificate of Occupancy for the dwelling under building permit # i . Rnt 1 gSSLLE. wAQS.FFAt1t_ 11-03-•03 Signature Date bpcont Applicant Address Date %( -011-63 VALUATION/FEE DETERMINATION oi CI( , sIs Finished (Livable Area); Main Upper Lower Other 5215). x69•°1' Total Square Feet Valuation Basement: Unfinished Conversion of Unfinished to Finished Plan Check Fee for Conversion Valuation Crawl Space: Subdivision Lot/Block Contractor °Witter - /y8, 4tg .ua Valuation 5176 '8. t = /pi 3 (o$;db Valuation »5? Xq,40 /9f3(0an Decks/Patios: Covered Valuation Q1aa.x aq. sV = 53akg. w OPen Valuation a op X (a < UD = a t(6D, Total Valuation Building Permit Fee Plan Review Fee Total BP & PR /8s, 852.60 /L?s,35 955,98 ag3Y.3 J Plans to be included for a Building Permit, must be on drafting paper at least 18"x24" and drawn to scale. Plans must include a floor plan, a concrete footing and foundation plan, elevations all sides with decks, balcony, steps, hand rails and guard rails, windows and doors, including the finish grade line. A section showing in detail, from the bottom of the footing to the top of the roof, including re -bar, anchor bolts, pressure treated plates, floor joists, wall studs and spacing, insulation, sheeting, house - rap, (which is required), siding or any approved building material. A window schedule. A door schedule. A floor framing plan, a roof framing plan, roof must be designed to withstand a 40 pound per square foot up to 7,000 feet in elevation, an 80 M.P.H. windshear, wind exposure B, windload of 15 pounds per square foot, and a 36 inch frost depth. All sheets to be identified by number and indexed. All of the above requirements must be met or your plans will be returned. All plans submitted must be incompliance with the 1997 UBC, UMC and 1997 UPC. 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(s) prepared by a licensed surveyor and has the surveyors signature and professional stamp on the drawing? Properties with slopes of 30% or greater must be shown on the site plan. NOTE: 106.3.1 (7.) 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 surveyors 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 also include any other buildings on the property, 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 a ply. Yesy_ 3. Does the site plan include when applicable 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? Yes ✓ 4. Does the site plan indicate the location and direction of the County or private road accessing the property? Yes 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? Yes ✓ 6. Do the plans indicate the location and size of ventilation openings for under floor crawl spaces and the clearances required between wood and earth? Yes ✓ 7. Do the plans indicate the size and location of ventilation openings for the attic, roof joist spaces's and so ts? Yes 8. Do the plans include design loads as required by Garfield County for roof snow loads, (a minimum of 40 pounds per square foot up to & including 7,000 feet above sea level), floor loads and wind loads? Yes v- 9. 9. Does the plan include a building section drawing indicating foundation, wall, floor, and roof construction? Yes ✓ 10. Does the building section drawing include size and spacing of floor joists, wall studs, ceiling joists, roof rafters or joists or trusses? Yes ✓ 11. Does the building section drawing or other detail include the method of positive connection of all columns and beams? Yes ✓ 12. Does the plan indicate the height of the building or proposed addition from the highest point of the building or addition measured at mid span between the ridge and the eave down to existing (undisturbed) grade contours? Yes ✓ 13. Does the plan include any stove or zero clearance fireplace planned for installation including make and model and Colorado Phase II certifications or phase II EPA certification? Yes ✓ No 14. Does the plan include a masonry fireplace including a fireplace section indicating design to comply with the Uniform Building Code Chapter 37? Yes No ✓ 15. Does the plan include a window schedule or other verification that egress/rescue windows from sleeping rooms and/or basements comply with the requirements of the Uniform Building Code? Yes ✓ No 16. Does the plan include a window schedule or other verification that windows provide natural light and ventilation for all habitable rooms? Yes ✓ No 17. Do the plans indicate the location of glazing subject to human impact such as glass doors, glazing immediately adjacent to such doors; glazing adjacent to any surface normally used as a walking surface; sliding glass doors; fixed glass panels; shower doors and tub enclosures and specify safety glazing for these areas? Yes ✓ No 18. Is the location of all natural and liquid petroleum gas furnaces, boilers and water heaters indicated on the plan? Yes ✓ No 19. Do you understand that if you are building on a parcel of land created by the exemption process or the subdivision process, are building plans in compliance with all plat notes and/or covenants? Yes i/ No 20. 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? If you do not have written permission from the association, do you understand that the plan check fee will not be refunded should the architectural committee deny or reject your building plans? Yes ✓ No 21. Will this be the only residential structure on the parcel? 7-1-IERE 5 AN Yes No iv" If no -Explain: Au X1 LAC/ Du E1114 Ca t7 LIST 22. Have two (2) complete sets of construction drawings been submitted with the application? Yes 23. Do you understand that the minimum dimensions a home can be on a lot is 20ft.wide and 20ft. long? Yes No 4 24. Have you designed or had this plan designed while considering building and other construction code requirements? Yes ✓ No 25. Do your plans comply with all zoning rules and regulations in the County related to your properties zone district? Yes No 26. 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 27. Do you understand that approval for design and/or construction changes are required prior to the application of these changes? Yes / No 28. Do you understand that the Building Department will collect a "Plan Review" fee from you at the time of application submittal 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 ✓ No 29. Are you aware that twenty-four (24) hour notice is required for all inspections? Inspections will be made from Battlement Mesa to West Glenwood in the mornings and from Glenwood Springs to Carbondale in the afternoons. All inspections must be called in by 3:30 p.m. the day before. Failure to give twenty-four (24) hour notice for inspections will delay your inspection one (1) day. Inspections are to be called in to 384-5003. Yes ✓ No 30. Are you aware that requesting inspections on work that is not ready or not accessible will result in a S47.00 re-inpsection fee? Yes No 31. Are you aware that you are required to call for all inspections required under the Uniform Building Code including approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy of the building? Yes ✓ No 32. Are you aware that the Permit Application must be signed by the Owner or a written authority be given for an Agent and that the party responsible for the project must comply with the Uniform Building Code? Yes ✓ No 5 33. Are you aware that prior to submittal issuance of a building permit application you are required to show proof of a driveway access permit or obtain a statement from the Garfield County Road & Bridge Department stating one is not necessary? You can contact the Road & Bridge Department at 625-8601. Yes No ex 1 ST1IU U 34. 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 person performing the work will be required at time of applicable inspection. Yes / No 35. Are you aware, that on the front of the Building Permit Application you will need to fill in the Parcel/Schedule Number for the lot you are applying for this permit on prior to submittal of a building permit application? Your attention in this is appreciated. Yes No I hereby acknowledge that I have read, understand and answered these questions to the best of my ability. p.R LESLIE wA1f.H- A II -o3 -o3 Signature ot'Owner Date Phone: 448 - S OG7 (days); 9 64 - 2-71 3 (evenings) Project Name: \A%ARE14AM / PADILLA RES1DENCE- Project Address: / SOI CAD ut. i ROAD 2 45, NEW CASTLE, CO 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. bpminreq 04/2003 6 Applicant PLAN REVIEW CHECKLIST ALrt eqP u,f{ Date /[•L1- 03 Building X/. f Engjneered Foundation Driveway Permit ✓Surveyed Site Plan ✓ Septic Permit and Setbacks Grade/Topography 30% _'Attach Residential Plan Review List L/Minimum Application Questionnaire )LI.4. Subdivision Plat Notes Q Fire Department Review Valuation Determination/Fees -Red Line Plans/Stamps/Sticker ,/Attach Conditions RogF d lroiv application Signed PIaan Reviewer To Sign Application Lazcel/Schedule No. 40# Snowload Letter- Mani Hms. GENERAL NOTES: Planning/Zoning Property Lin = Setbacks 30ft Stre Flood PI Buil Setbacks g Height Zo ' g Sign -off Ro • • Impact Fees A/DRC Approval de/Topography 40% Planning Issues Subdivision Plat Notes Garfield County Road and Bridge Department P.O. Box 426 Rifle, CO 81650 Phone -(970)625-8601 Fax- (970)625-8627 Invoice Invoice Date: 11/13/2003 Invoice Number. 134 Bill To: Tom Lippitt 1501 CR 245 New Castle , CO 81647 Driveway Permit Number: 134 $75.00 per Driveway Permit. Driveway Permit Fee: $75.00 Total Due: $75.00 Thank You! CL 11,1 S9/9 4/a4/&3 kap O c O O w 5) 0. co 0 N d a W 0 1 rn d c 0 � L 0a N 0 N N L 0 0 O (a 16 O O U N 0) C 0. 040, 0 O N 0a CD Cr) 0 ti 01 d c O L 0a N d w CON r 01 0 O 5d d v N d d d w C c c co O 0 «p2 V La � (0 0) N C :.F.. 0 v O y0 0 d ow N .0 c C ,To C to N > d W in L E d 0. .5 d d � d '0 N C C CO O E 3 ` 0 v N 0) N C w9 w0 0d 0. - N C > I have this d premises and a 21. 0. m c a a E 0 0 1 0 ,kt:4 v d � 0 00 A 0 d r `o 0 d 0 0. CO) • m a c E c 0 0 E O a p C > d 0 o .0 u m .c O M •F Aa L 9 0 w O 0 T Od L 0 C 16 0 N 0 C 3 ection at 970-384-5003. ction(s) have been made, call for i .d. A 0 Building Inspector Phone (970) 9454212 0 `O O U N O) c 0. N N Or 3°N° m ch O 1 c) c c O r Oa (11 0) 3 N N L o co 0 csi Job located at 15o3 ob located at it O V Permit No. v r u a c c 0 N 7 E 0 .0 • 0) O t10 C and O .0 o w O d YW .0 d O c r a 2 m r N 7 dd N G1 0▪ 7 • d ✓ ▪ C 0 0 co • 0 ' `1 w ▪ 0 2v N O) N_ t 0 w .O 0 N N .. - C • C 7 IA ;F: c 010 • E 0. - 0) When correction(s) have been made, call for inspection at 970-384-5003. have been made, call for inspection at 970-384-5003. 0 O U 1- `o u c Lc Phone (970) 945-8212 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit Iv' 3 8 8 5 Assessor's Parcel No. 109 8th Street Suite 303 Glenwood Springs, Colorado 61601 Phone (303) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY \. t�1 11! Owner's Name V1L.CJt-Qh( (Jjt Present Addre System Location This does not constitute { a building or use permit. Phone 9 Qc 4 — Legal Description of Assessor's Parcel No. SYSTEM DESIGN /ono (5b3Cc)s(5 Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) 3 t /G" Ar • Sep 1:fi ldre 04a (cao4A 7n S 7 8 lb L ei-GL C' � .. bQ .� 3 / / - S fly 77ZGir. a,4 /%5Gm Ge+.J Ch0...ecto VL AX'S t 590 Required Absorption Area - See Attached Special Setback Requirements: Date 4/-2 - 7 7L Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity ' 00-0 Septic Tank Manufacturer or Trade Name l Septic Tank Access within 8" of surface 1' Absorption Area / 15.e. 1 I J Gz Absorption Area Type and/or Manufacturer or Trade Name 3.+ j- f Jt L ( Q 3 6, f Adequate compliance with County and State regulations/requirements ( Other �.-// Date 7/ ' L' 1 Inspector Us( 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 off ice 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 ($500.00 fine — 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT 4 9 No. Job Address \ 503 Q Owner �4 ContractoretC' lQr Assessor's Parcel No 31Y5 \k Date k -- Gr-.) BUILDIRD PERMIX CARD i L1-5 N Pty INC EtSi{-e_- k-� y AddressVk C 5fi �\,K111"dkPhone #��l`'A R11 . �� Address Phone #�.�k-ak l LH Zoning Setbacks: Front Soils Test Footing 1245-03 l - Foundation /= -2) Ci Grout Underground Plumbing Rough Plumbing Framing R -L? Insulation g I n Roofing Drywall 8-(fe- off Gas Piping 4 &fi• - e kJ -MILL Oft-UCI 5:CO-COLLi apt ty5:4-' NOTES Weatherproofing Mechanical Electrical Rough (State) Electrjo Fi (State) 7-5 as 6 (4.3 . Final 'Fri hecklist Completed9 Certificate Occupancy # Date Septic System # Date Final I 5 - -/(,-'af' ktkJ — Other (continue on back) BUILDING PERMIT GARFIELD COUNTY, COLORADO Date Issued4 . 07..Zoned Area Permit No cc. `` 54 AGREEMENT In consideration of the issuance of this permit, the applicant hereby agrees to comply with all laws and regulations related to the 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 Inspector 1 I IMMEDIATELY BECOME NULL AND VOID. Use ! .a a - I . — S ]& iS . ° Add r DJptio��-tea -_ Owner `ll' "i*Ir7SUNglien'i*. atractor��1i �i— Setbacks Front Side Side Rear This Card Must Be Posted So It is Plainly Visible From The Street Until mal Inspection. INSPECTION RECORD Footing /y -/j pj ,O'- Foundation /2 -?J t i 01 Underground Plumbing Insulation g-/0_opt Aft -- Rough Plumbing 6 -a;- _.< 7, 4,4 Drywall g -/L. -O Chimney & Vent S3-pV,Ont • 7(570 Gas Piping L - Q -. _ e .: 1 ICC _ Final Septic Final ' Framing 3 3 -•i y ti (To include Roof in place and Windows and Doors installed). Notes: ALL LISTED ITEMS MUST BE INSPECTED AND APPROVED BEFORE COVERING - WHETHER INTERIOR OR EXTERIOR, UNDERGROUND OR ABOVE GROUND. THIS PERMIT IS NOT TRANSFERABLE Phone 384-5003 109 Stir -Street County Courthouse Glenwood Springs, Colorado. APP- • VED ' ' " I,.ts t -.INA' Date y IF PLACED OUTSID - COVER WITH CLEAR PLASTIC N 00° (17 S2 'E o / 1 v,t ``111 I N I )24-o" L e _� ' I , /W'o''11' 0 IN Lid 1 7) 1771 Q trt X A • v nJ 4 i 0 N T �1n — rl � n r m