HomeMy WebLinkAboutApplication- PermitGarfield County
Building, Sanitation,
& Planning Department
108 8th Street, Suite #201
Glenwood Springs, Co. 81601
Office- 945-8212 Inspection Line- 384-5003
NO. 099
Job Address 309 R /03CA.n./.Y-4rr 9, a fI b'�3
Nature of Work Building Permit r, Q
Use of Building
Owner ]� — k- c>� C4 v 5 r� 1^ l
14-C
Contractor ,y 6- 4x—W✓1
-ou^Q_ iI1a - /' 1_
Amount of Permit $ /51-5 t791Date 3'! Y 0251/ad2Zj
Clerk ` Cwt,-**,
Permit No:
GARFIELD COUNTY BUILDING PERMIT APPLICATION
108 8'° Street, Suite 201, Glenwood Springs, CO 81601
Phone: 970-9454212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
Parcel/Schedule No: 2.39S- 1 a 3 -60 - ]92 S -
i1 H-
AGREEMENT O$s % g3 _ /
PERMISSION 1S HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR ANDIOR THE AGENT OF THE CONTRACTOR OR OWNER T CONSTR CT
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 30.28.201 CRS AS 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 IT 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 TBE CORRECTION OF ERRORS IN SAID PLANS, 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 LIABLITIES BY GARFIEID 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.
Garfom.003
Oecep-09-
J HEREBY ACK.YOWLEDGE THAT 1 HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIA
Job Address:
�3 (�COO � R,D 2 z
3 0 c 7 C tZ � C8
1 Lot No: Block No: Su d. / Exemption:
2
Owner:
co%F)Di /fa D f4_,^ _101voSciL
Address
3c)..)-"/ CQ 10 1
Ph:
7cU `/ - &U y 5-
Wk Ph:
3
Contractor:
MC-Kvj C LI S77 RLDAC
Address:
ISH S,tb--, Cw1L-.
Ph:
9(n -S `8/0
Ic. No.
/O%) (2
4
Architect/l!ngineer:
Roil Roho..-c,,J
Address:
Ph:
5
763.0 47
uu No.
9X '6701
5
Sq. FL of Building:/
/OP5
Sq. Ft. of Lot:
/Oa.s0�
Height: to
I7-
No. of Floors:
6
Use of Building:
RQ%S,o24?.4L
7
Describe Work: 2 b, K .) rti
New R�SIOeN�� - i'�1 ►e e� 1.--41b8
Class of Work: New o Alteration ❑ Re °se V
o Addition o Move
9
10
Garage: o Single
o Double
Carport: o Single
o Double
o Driveway Permit pr..., On -Site Sewage Disposal o Site Plan
(Septic)
11
Valuation of Work: $
Adjusted Valuations: $ j0 / ,/� CPO
-t
12
Special Conditions:
NOTICE
A SEPARATE ELECTRICAL PERMIT IS REQUIRED AND MUST BE
ISSUED BY THE STATE OF COLORADO.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR, IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 180 DAYS AT ANY TIME AFTER WORK 15 COMMENCED.
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL
PROVISIONS OF LAWS GOVERNING THIS TYPE OF WORK WILL BE
COMPLETED WITHIN WHETHER SPECIFIED HEREIN OR NOT. THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY
TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAN REGULATING CONSTRUCTION OR THE PERFORMANCE
s CONSTRUCTION.
aft ! i,/ C) 0
Plan Check Fee:
6494.97
Permit Fee:
93o. '7
Total Fee: Dated Permit/issued:
1585.7'`
OCC Group:
�- 3
nst. Type:
A�
r.r`
Zoning:
Setbacks:
Manu. Home:
ISDS No. & Fee: /�(�(f
Ct/
113.D
T
la
C
pr tesseisiatiat
B i -D C.
APPR 8 /DATE "
SEPT.
iV /DATE
AGREEMENT O$s % g3 _ /
PERMISSION 1S HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR ANDIOR THE AGENT OF THE CONTRACTOR OR OWNER T CONSTR CT
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 30.28.201 CRS AS 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 IT 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 TBE CORRECTION OF ERRORS IN SAID PLANS, 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 LIABLITIES BY GARFIEID 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.
Garfom.003
Oecep-09-
J HEREBY ACK.YOWLEDGE THAT 1 HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIA
The following items are required by Garfield County for a final inspection:
1. A final Electrical Inspection from the Colorado State Electrical Inspector
2. Permanent address assigned by Garfield County Building Department posted where
readily visible from access road;
3. A finished roof, a lockable house, complete exterior siding, exterior doors and windows
installed, a complete kitchen with cabinets, a sink with hot & cold running water, non-
absorbent kitchen floor coverings, counter tops and finished walls, ready for stove and
refrigerator, all necessary 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 1997 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 THE ABOVE
ITEMS HAVE BEEN COMPLETED.
****CANNOTOCCUPY 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
PREMISE 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/4 75 9C -(Y
'P
Signature Date
BpcontO82002
VALUATION/FEE DETERMINATION
Applicant eTOrtzscn ([23.33 Subdivision
Address 3059 C & 103 Lot/Block
Date / lig 11 o3 Contractor
Finished (Livable Area):
Main /0S5 4
Upper
Lower
Other
Total Square Feet
Valuation
Basement:
Unfinished
Conversion of Unfinished to Finished
Plan Check Fee for Conversion
Valuation
Garage:
Crawl Space:
Valuation
Valuation 1085 4 q
Decks/Patios:
Covered
Valuation 9 S " 2')
Open
Valuation Z2(0 i !Z
Total Valuation
l� c Kt Custom'13 /P/'c
74, 84,SS
Z 352
304 3Z
10414
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 fetish 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 corner 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 corner lot. Special
setbacksdo a ply.
Yes
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
2
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 agd soffits?
Yes 7
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
9. Does the plan include abuilding 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 column 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 (un isturbed) grade contours?
Yes
13. Does the plan include any stovepr zero clearance fireplace planned for installation including
make and model and Colorado/Phase II certifications or phase II EPA certification?
Yes No
3
14. Does the plan include a masonry fireplace including a fireplace section indicating design to
comply with the Uniform Buildin ode 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 andven 'lation for all habitable rooms?
Yes 7 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 X 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 / 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 c°mmittee deny or reject your building plans?
Yes / No
21. Will this be the only residents cture on the parcel? (/Y
Yes No If no-Explain..�Aw./1 Q.By
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
inspec7 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 applic tion 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 p it?
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 7.00 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 U iform 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
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 tijae 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/ScheOule Number for the lot you are applying for this permit on prior to submittal
of a buildin ermit 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.
a� eoQ�
Signature of nor \�
Phone: g'(c->- 7� /
Project Name:
Project Address:
Notes:
(days);
(a-36-03
Date
(evenings)
-30\vvasna CAAa- Akc,2
30 i7 e-QysTAL Sot, -tis Ro cc 103
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
FROM : CEDAR RIDGE FARM
FAX N0. : 970 963 1703 Oct. 30 2003 03:43PM P1
Agricultural Employee Affidavit
Me 3 V -3L/2
Garfield County
BUILDING & PLANNING DEPARTMENT
1, e° /yv state that the residential structure
describ below will be o pied solely as an agricultural employee dwelling unit
provided to an individual and related family member who is/are employed in an
agricultural use, including farms, garden, greenhouse, nursery, orchard, ranch, small
animal farm for production of poultry, fish, ft>rbearing or other small animals, as
prescribed in Garfield County Zoning Resolution Section 3.02.01 and in Section 2.02 02
Agricultural Land, on the property at which the dwelling is located and further, pays no
rent.
It is agreed that proof of employment, in the form of Internal Revenue Service Forms
W-2 or 1099 for each person employed es described above will be submitted to the
Garfield County Building and Planning Department upon request by the county.
It is agreed that this property will not be sold to another party without representing that
the agricultural employee dwelling structure is for agricultural employees only and may
not be used for any other purpose
Property and Building Description: -
Address 05— (O U l / Q a 1 0,3 C a f co yYdoJ e7 t! U
Assessors Parcel Number '2 3 93 —117—S �o 7,7'E' &l 23
Building Description L *sus P
Building Square Feet Habitable NI i
Building Permit Number
ISDS (Septic) Permit Number
Owner PO,/vvia CO.
Owner Address 3 0 5" ! C 0
Date Sepr I0t 7,0
1
Witness
/63
(Signature)
109 8th Street, Suite 303, Glenwood Springs, Colorado 81601
(970) 945-8212 (970) 285-7972 Fax. (970) 384-3470
FROM : CEDAR RIDGE FARM
FAX NO. : 970 963 1703
VOID n CORRECTED
Oct. 30 2003 03:43PM P2
PAYER'S name, Street 'dorms city, slate. ZIP code, and lelepMna no.
Cedar Ridge t'arm L.L.C.
3059 County Road 103
Carbondale, CO 81623
1 Rent
2 Royalties
OMB No. 1545-0115
rr QO2
Fad 1099-MISC
Miscellaneous
Income
5
3 Omer income
$
4 Federal Income w MTh */
PAYERS Federal Idenldcatca
nuns.
36-4318965.
RECIPIENTS Conflate
number
ce6 CS-ss4�
CQ3-sq-qt 53
5 Flthlrlp boat proceeds
$
6 Weal 116 Net cae pares
Copy C
For Payer or
State Copy
RECIPIENT1 nAne. nivel .ddrw fnfNdng apt 110.1. 13111. orale. arm ZIP Does
PAIGE POLLARD
6488 COUNTY ROAD 233
SILT CO 81652
Account number [optional)
2nd TIN not
7 NWmplpyee fpnpensalglt
4800.00
$
0 Substitute panne in awlot
dmeends or behest
and Mesas
Crop nwrenoe proceeds
%/ rS
B Payr made
15,030 rore of GrimmerGrimmerm
product .% e014,1
Yaoperq for resale
11.
If Excess golden parachute
peynenta
$
14 Grofe protecdS ppld b
IA atom*,
$
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2002 General
Instructions for
Forms 1099,
1098, 5496,
and W -2G.
15
16 State tee withheld
$
17 STolelPayr`s SIM no
16 $tate faire
$
5
Form 1099-MISC
Department N the Treasury •
Internal Revenue Service
2002 FORM N IMISCPA'
Garfield County
Road and Bridge, District 1
7300 Hwy 82, Glenwood Springs, CO 81601
970-945-1223 ph. 945-1318 FAX
Date: 10-30-03
To: Building & Planning
From: Bobby Branham
Re:
For
Carbondale CO 8181623
970-704-0645
Location: Same
Scope of Work: Obtain building permit
Road and Bridge Concerns: This property lies outside the system of maintained county
roads, and is therefore exempt from County driveway permit requirements.
Bobby Branham
Dist.1 Road and Bridge
PLAN REVIEW CHECKLIST
Applicant, r,n.
Building
✓Engineered Foundation
'veway Permit
✓ Surveyed Site Plan
Septic rniit and Setbacks
ade/Topography 30%
(--Ke-tach Residential Plan Review List
Mcilmum Application Questionnaire
/.j 4. Subdivision Plat Notes
It 11. Fire Department Review
✓ Valuation Determination/Fees
`Red Line Plans/Stamps/Sticker
,j•4 Attach Conditions
✓Application Signed
an Reviewer To Sign Application
LarceUSchedule No.
ailL40# Snowload Letter- Manf. Hms.
GENERAL NOTES:
Date II -2-9.03
Planning/Zoning
Property Line Setbacks
30ft Stream Setbacks
Flood Plain
Building Height
Zoning Sign -off
Road Impact Fees
HOA/DRC Approval
Grade/Topography 40%
Planning Issues
Subdivision Plat Notes
UR 03 fie •*Sr°A0
0° r 61) i/s/Dy
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit Nc 3883
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT'
PROPERTY
Owner's Nam
!"4 W`Co(e
-/054911,y �,✓�; Present Address o5�f C" ta Cd'
3tI �7 Ciuc (3trko4LeRk g/6
Assessor's Parcel No.
This does not constitute
a building or use permit.
Phone rlo ci- C 64.5
System Location
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
/OW c,.4
`
a39 3 -1a3 -5o ,)iic
Septic Tan Capacity (gallon)
-� TIT
Percolation Rate (minutes/inch)
Required Absorption Area - See Attached
Special )Setback Requirements -
Date �k 1)-`03
Other
Number of Bedrooms (or other)
71A1-uCNF) / 7 Legit)
Inspector
-L • Sl' weJIMR-14—
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity /14
/oo°k? (
2 75.a p G Qr 1 p y D�:4og
20 Q ssrrs
z4 un.fr)JIC-n )18
•
Septic Tank Manufacturer or Trade Name •t/a")�'---
Septic Tank Access within 8" of surface
e
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name ^x --rte,
Adequate compliance with County and State regulations/requirements
Other
Id .4 9
Date i '/ Inspector -t ,'/mei-l--
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
•CONDITIONS:
1. All installation must comply with all requirements of the Colorado Stale 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 Of tense ($500.00 fine — 6
months in jail or both).
White - APPLICANT Yellow - DEPARTMENT,
COUNTY OF GARFIELD - BUILDING DEPARTMENT
CORRECTION NOTICE
108 8th St., Suite 201 Glenwood Springs, Colorado
Phone (970) 945-8212
Job located at 305?
Permit No. -6
94GI
Ode /p3
I have this day inspected this structure and these
premises and found the following corrections needed:
6 (And/, f- Af SKS _
i)assike Iirgse r-(O-YV.l142,Iii,:a
i nn
I.7J' tr len 1,1 64'0 4064-,Lcow, 2J
You are hereby notified that the above correction must be inspected
before covering.
When correction(s) have been made, call for inspection at 970-384-5003.
Date 4- - I 2Qov
Building Inspector
Phone (970) 945-8212
12/06/2004 16:03 9708765711 AVA BUWLE5
OVOID ❑CORRECTED
AYERS new. not Meats, city, num SM wap, mid NYpla.. nu
Cedar Ridge
3059 County
Carbondale,
Farm L.L.C.
Road 103
CO 81623
1 Rena
$
$ Anna
$
01.0 Nr. 1545-0115
20i
3
Ferro 1009•MISC
rr,ur us
Miscellaneous
Income
3 Oar emea
$
4 Farm baser m eeeaad
$
PAVERS Falai MwtYn
MROM
36-4310965
RECPIE % aenlamaon
nallper
523-59-9153
a Fb t* a peal Mande
$
0 Waal W halal w paws
$
Copy C
For Payer
RECIPIENTS Iced. adeMa OM RP ad.
PAIGE POLLARD
6488 COUNTY ROAD 233
SILT CO 81652
7 Maanpvy a eeeawn lca
$
5456.00
a 64101n Waft n hl d
SSA or .n
$
5 Paye nab diet ISN d
Rear a nm at worn
meat a • lam
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10 Opp gammon enMer
$
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j��/////Aes
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ad gmnll
u
IA Es a.; pander
WASS
$
14 don proceed- pant
r tawny
$
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
1003 General
Instructions for
Fenn 1090,
1095, Nis,
and W -2G.
16
14 EMS r MdaM
S
$
er •
17 SMSPyen Ma M.
It Sal Stamm
Din 1099-MISC
17) VOID ❑CORRECTED
39160047
OM•nmeM 01 w Tracy • aalrl Rennin Sano.
PAVERS nam area Sena My. MN. 77 pace. eat edaatlan eo7
1 Rana
$
a Roman
$
0141 Net /0454115
2@'03
Fern 1099-MISC
Miscellaneous
Income
3 Gala ammo
$
PAYERS Poling Mnaaajp,
numb.
RECIPIENT'S Idnri*Ys
lumen
S Rite and emceed&
$
4 Fader pampa an Masa
$
11 MPS r MO r ppm
Copy C
For Payer
RECIPIENTS name Mane and 21P rade
Amason MINS game
5s 114 ma
0
71Mempbme arpmadm
$
a anew PPM* In laod
OS* it Framed
S
II Palm seeds PAM Mae a,
KM or woe IP Ma
Piech a•b«
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11
M Cap blaaaaa Naas&
$
13 Sem plea paaaala
Pay rd&
14 Gem placer peed
M earmsy
For Privacy Act
and Paperwork
Redla<tlon Act
Notice, see the
1003 General
aNlrlmuons for
Fanny 1009,
1090, 6495,
end W2G.
13
ram 1096-MISC
1a Sr d mita
S
17 SWa12apry Bala no
1a Some Iran
a
$
31611100047
Conmel lard M h Wean - bMaW Revenue Servo
4
a.
1
Cedar Ridge Farm L.L.C.
3059 County Road 103
Carbondale, CO 81623
PAIGE POLLARD
3059 COUNTY ROAD 103
CARBONDALE, CO 81623
Employee Paystub
Employee
Check number. Pay Penod: 11/162004 - 11/30/2004 Pay Date: 12/012004
SSN Status (Fed/State) Allowances/Extra
PAIGE POLLARD, 3059 COUNTY ROAD 103, CARBONDALE. CO 523-59-9153 Single/Single Fed-2/0/CO-2/0
81623
Earnings and Houts Qty Rate Current YTD Amount
Salary
Taxes
750.00 10,500.00
Current YTD Amount
Federal Withholding
Social Security Employee
Medicare Employee
CO - Withholding
-43.00
-46.50
-10.87
-21.00
-574.00
-651.00
-152.25
-286.00
-121.37 -1,663 25
Net Pay 628.63 8,836.75
Cedar Ridge Farm L.L.C., 3059 County Road 103, Carbondale, CO 81623
No U, tit f
Job Address
Owner
Assessor's Parcel No.
Date nia-( ).-3
BUILDING PERMIT CARD
3059' CR I 03 l�du et,, ¢ Cos/603
9 Pao - Address 36" C .t.to3 C' te—
Contractor
Setbacks: Fro
2264. Address 158'SW:toLA ala
Rear
b"
0M1. °wipe to
RH LH
INSP CTIONS
Soils e !Ch
Footing / I -ZS---it? ' �'���
Foundation /2 -Z -o 3 FLr
Grout
Underground Plumbing /'Z0 -p:1
Rough Plumbing / '017*
Framing /—�3—01 T
nsulation I-ai Q`/
Roofing
Drywall 2-2 -OW/-
Gas Piping 1- 40-0c-0 -44-
L
Phone # 1-70 11 o c[
Phone # R/O` 5$4o(tt
Zoning
Weatherproofing
Mechanical
Electrical Rough (State)
Elect9calFinal (S ate)
Final) _S d ecklist Completed? i
Certificate Occupancy #
Date
Septic Systemm#��'3 /l
Date llfs'�r�3
Other
NOTES
Final 1/S nf/ ' / / CC
u&►ArtA\ a -Kiri 2$fce
Az7; off (continue on back)