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Home My WebLink AboutApplication-PermitGarfield County Building & Planning Department 108 Bth Street Suite 401 Glenwood Springs, CO 81601- Phone: (970)945-8212 Fax: (970)384-34 70 Project Address 2425CR137 Glenwood Springs, CO Owner Information Pan:el No. 212324200176 Address 2425CR137 f ) I . Subdivision Robert Oddo Glenwood Springs CO 81601 Permit NO. BLRE-5-10-1566 PermU Type: Residential Building Warl< Classification: New Permit Status: Active Issue Date: 6/4/2010 Expires: 12/01/2010 Section Township Range Phone Cell 970-945-1006 Contractor(s) Phone Primary Contractor Required Inspections: Proposed Construction/ Details Barn/ storage FEES DUE Fee Plan Check Fee Residential Building Fee Total: Friday, June 4, 2010 Amount $333.09 $512.45 $845.54 Valuation: Total Sq Feet: FEES PAID $ 36,828.00 2046 Inv Total Paytype Amt Paid Amt Due Inv# BLRE-5-10-20250 S 845.54 Check# 1469 Credit Card $333.09 $512.45 $ 0.00 Forlnspectlons call: 1 (888)868-5306 Inspection IVR See Permit Record Building Department Copy 2 Building Plan Review Description of Work: Barn/ storage Bin#: 0 Location Address: 2425 CR 137 Glenwood Springs, CO Case M.nager: David Bartholomew Plan Case Number: BLDG-5-1 ~O Parcel: 212324200176 Application Date: 0512812010 Building ____ / _____ Engineered Foundation __ N...,.t ..... 1/l __ Driveway Permit --~---Surveyed Site Plan ----~---Septic Permit and Setbacks __ / ___ Grade/Topography 30% --'/"--__ Attach Residential Plan Review List __ / ___ Minimum Application Questionnare __ f-1...,.f_'A __ .Subdivision Plat Notes __ tJ+,V_A __ Fire Department Review _ __.;..i/ ___ Valuation Determination/Fees --~---Red Line Plans/Stamps/Sticker __ V' __ _,Attach Conditions __ t/ ___ Application Signed _ _.iL_..., .. _ .... Plan Reviewer To Sign Application __ /' ____ Parcel/Schedule No. _M-+-,t_'/I __ . -· 40# Snowload Letter -ManlL Homes _/JJ....., 1 ,......1/ /l __ Solls Report Contcicts Owner: Robert Oddo Applicant: Robert Oddo Applicant Phone: 970.945-1006 Em alt Planning/Zoning __ ./ __ ___...Property Line Setbacks -~-0-~ __ 30ft Stream Setbacks I __ /J..,.~-/l~_Flood Plain 7 ____ _..Building height __ / ___ zo.ning Sign-off __ 10 ..... 1_~_-Road Impact Fees __ M,..f_'lf~,,_,HOA/DRC Approval __ M+~-11 __ Grade1Topography 40% '/ --'v _____ _.Planning Issues Nj/I ---1 ----'tii:Subdivision Plat General Comments: 4 !Jp Ut ~r#.8M /P1'm1/ /et ?I 4H ,&/i~ ffe _;5ps ;:t>e ~.fr.6, 8",,1$ ¢ ftl'Hf'/'~kJ ·, P 5/ZJ <t5 JpJ 07 7.f CM Applicant: Job Address: Subd-Lot/block: FEE ESTIMATE FOR S/F STICK BUILT HOMES 'SARE ESTIMATES UNTIL FINAL PLANS ARE REVIEWED) FINISHED LIVING SPACE: sq.ft X 74.68= UNFINISHED BASEMENT: sq.ft X 41.00= CRAWLSPACE: sq.ft X 9.00= GARAGE/ .s-k.-__ 4 '~<:z ___ __.___i....;..=._~ ~04b sq.ft X 18.00= 3.', e:ie } UNCOVERED PATIO/DECK: sq.ft X 12.00= COVERED PATIO/DECK: sq.ft X 24.00= ( If/SC: MISC: TOTAL VALUATION: , Co ~I&>/ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SECTION WILL BE DETERMEND BY GARFIELD COUNTY BUILDING & PLANNING PLAN REVIEW FEE: $0.00 PERMIT FEE: TOTAL: $0.00 PERMIT: SEPTIC= PERC: 2 3 4 5 6 7 8 9 Describe Work: JO Class of Work: 11 Garage: 12 Driveway Permit: GARFIELD COUNTY BUILDING PERMIT APPLICATION 108 8111 Street, Suite 40!, Glenwood Springs, Co 81601 Phone: 970-945-8212 /Fax: 970-384-3470 I Inspection Linc: 970-384-5003 www.!?arficld-county.com 6ws Sq. Ft. or Acres of Lot: ew o Alteration o Addition Septic: o Attached o Detached Owners valuation of $ NOTICE No. of £1L>rs: o Communit 4o. a Aulhorih-. This application for a Building Permit must be signed by the Owner of the propcny, described abO\"C , or an authorized agent If the signature below is not that of the Owner, a separate letter of authority, signed by the Owner. must be provided with lhi s Application. J.ec:nl Ac~s. A Building Permit cannot be issued without proof of legal and adcqumc access to the propcny for purposes of inspections by the Building Dcpanmcnt. Olhcr Permits. Multiple scpar.uc pcrmll.$ may be required: (I) S1111c Elcc1rical Permit, (2) County ISDS Pcnnil. (3) another pcrmit required for use on the propcrty idenlilied abo\"C, e .g. S1111e or County Hi&hway/ Road Access or n State Wastewn1cr Discharge Pennit. Vnid Permit. A Building Pennie becomes null and void if the work au1horized is not corruncnccd within 180 days of Ilic dale of issuance and if work is suspcnded or nl>andoned for a period of 180 days after commcnccmcnL CERTIFICATION I hereby ccnify that I h:!ve rend this Application and that the information comaincd above is true and com:ct. I understand that the Building DcfW1mcnt :icccpts the Application. along with the plans and spccific;11ions nnd other data submined by me or on my behalf (submituls). b3Scd upon my ccnilication 3S to ilCCuracy. Assuming completeness of the submiculs and appro\'al o f thi s Application. a Building Permit will be issued granting permission to me , as Owner. 10 construc t the scruciure(s) nnd facilities detailed on the submittals re\'iewcd by the Building DcpanmcnL In consideration of the issuance of lhc Building Permit. I agree that I and my agents will comply with provisions of any federal. state or local Jaw rcgulating the work and the Garfield Counly Building Code, !SOS regulations and applicable land use regulations (County Regulatioo(s)). I acknowledge that the Building Permit may be suspended or """oked. upon notice from the County. if the location, construc1ion or use of lhe structure(s) and facility(ies ), described abo,-c , arc not in compliance with County Regulation(s) or any other applicahlc Jaw . I hereby granl permission to the Building Ocpanmcnt to enler the propcny. described abovc, 10 inspcct the work . I funlicr acknowledge that the issuance of the Building Permit docs not prevent the Building Official from : (I) requiring the con<:l:tion of errors in the submittals, if any, disco\'ercd ofter issuance ; or 121 stopping construction o r use of tltc struciun:(s) or facWty(ies ) if such is in violation of County Rcgulation(s) or ony other applicable law. Review of this Application, including subminals , and inspections of the work by the Building Depanmcnt do not constitute an acceptance of rcsponsihilily or liability by the County of errors. omissions or disc · s the Owner, I aclmowledgc that responsibility for compliance wi1h federal. s1a1c and local laws and County Regulati ons rest with me and my authoriz.cd agents. including without Ii uon m an:lti designer. en · r n or bu· r. EREBY C WLEDGE Tl DANDUNDERSTANDTHENOTICE&CERTIF ATION 5,;;g 0 DATE STAFF USE ONLY Special Conditions: Fu.+ure At>U ri()+ perm1fkcA ~ Af f/Zdlllt(. Adjusted Valuation: Plan Ci""'" ......... I PPl"'mit Fee: Manu home Fee: Misc Fees: $ 36,, <l/l?. ~ -'>3~ o? I Jf5/Z. 'If ISDS Fee: Total Fees: Fees Paid: Balance Due: f 5&& ~sue Date: ISDS No & Issued Date: ,, 7~.'!P-q18.S' ~3:,.oq S'"@S. qs -Psw=t- Setbacks:;.=: IZ s OCCGroup: Const Type: Zoning:~ £"0 -25-1~ Ll -3LB 47~/~ 6ftdd' 4~/~ 6/~o APPROVAL DATE APPROVAL DATE \ 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 and posted at the structure and where readily visible from access road. 3) A finished roof; a lockable building; completed exterior siding; exterior doors and windows installed; a complete kitchen with cabinets, sink with hot & cold running water, non-absorbent kitchen floor covering, counter tops and finished walls, ready for stove and refrigerator; all necessary plumbing. 4) All bathrooms must be complete, with washbowl, tub or shower, toilet, hot and cold running water, non-absorbent floors, walls finished, and privacy door. 5) Steps over three (3) risers, outside or inside must be must have handrails. Balconies and decks over 30" high must be constructed to all IBC and IRC requirements including guardrails. 6) Outside grading completed so that water slopes away from the building; 7) Exceptions to the outside steps, decks, grading may be made upon the demonstration of extenuating circumstances., i.e. weather. Under such circumstances A Certificate of Occupancy may be issued conditionally. 8) A final inspection sign off by the Garfield County Road & Bridge Department for driveway installation, where applicable; as well as any final sign off by the Fire District, and/or State Agencies where applicable. A CERTIFICATE OF OCCUPANCY (C.0.) WILL NOT BE ISSUED UNTIL ALL THE ABOVE ITEMS HA VE BEEN COMPLETED. A C.O. MAY TAKE UP TO 5 BUSINESS DAYS TO BE PROCESSED AND ISSUED. OWNER CANNOT OCCUPY OR USE DWELLING UNTIL A 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 C.O. for the building identified in the Building Permit. OWNERS SIGNATURE DATE Bapplicatio ndecember2007 GARFIELD COUNTY BUILDING AND PLANNING 970-945-8212 MINIMUM APPLICATION REQUIREMENTS For SINGLE FAMILY DWELLING CONSTRUCTION Including NEW CONSTRUCTION ADDITIONS ALTERATIONS And MOVED BUILDINGS 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. TWO (2) SETS OF CONSTRUCTION DRAWINGS & TWO (2) SITE PLANS MUST BE SUBMITTEDFOR ALL APPLICATIONS. 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. Any project with more than ten (10) occupants requires the plans to be scaled by a Colorado Registered Design Professional. 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 arc required to indicate appropriately and to submit the completed checklist at time of application for a permit. Plans to be included for a Building Permit, must be on drafting paper at least 18"x2411 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 and original grade. 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. Engineered foundations may be required. 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, a 90 M.P.H. wind speed, wind exposure B or C, 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 in compliance with the 2003 IR.C, and 2006 IECC. 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 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 buj!ding envelope as it is shown on the final plat with the proposed structure located within lQe..e1Welope . Yes ---- 2. Docs 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 pennit on is located on a comer lot. Special setbacks do apply. ____- Yes ~ ---- 3. Does the site plan include when applicable the location of the l.S.D.S. (Individual Sewage Disposal System) and the dis nces to the property lines, wells (on subject property and adjacent properties), st s or water courses? Yes ---- 4. Does the site plan ~te the location and direction of the County or private road accessing the property?~ Yes ----- 2 Q,-"'i, V Have you provi.i{ci any RESOLUTIONS and/ or LAND USE PERMIT(S) associated with this property? Yes if Yes please provide a COPY. No ____ _ 6. Are you aware that prior to submittal of a building permit application you are required to show proof of a legal and adequate access to the site? This may include (but is not limited to) proof of your right to use a private easement/right of way; A County Road and Bridge permit; a Colorado Dept. of Highway Permit, including a Notice to Proceed; a permit from the federal government or any combinatio~. _You~ contact the Road & Bridge Department at 625~8601. See phone book for otheragen~ Yes ----- 7 . Do the plans include a foundation plan indicating the size, location and spacing of all reinforcing steel in ace~ the IRC or per stamped engineered design? Yes ----- 8. Do the plans indicate the location and size of ventilation openings for under floor crawl spaces and the clearances requ~twcen wood and earth? Yes ~ No ----- @Do the plans indicate the size and location of ventilation openings for the attic, roof joist spaces and soffits? Yes No ----------- 10 . Do the plans include design loads as required by Garfield County for roof snow loads, (a minimum of 40 pounds per~ foot up to & including 7,000 feet above sea level), floor loads and wind loads? ~ Yes ------ 11. Does the pl.an ~inc~ building section drawing indicating foundation, wall, floor, and roof construct~ Yes ------- I 2. Docs the building sectio awing include size and spacing of floor joists, wall studs, ceiling joists, roof rafters · · or trusses? Yes ------- 13. Docs the building section dra · g or other detail include the method of positive connection of all columns and beams? Yes -------- 14. Does the elevation plan in icate the height of the building or proposed addition from the undisturbed grade e midpoint between the ridge and cave of a gable or shed roof or the top of a flat ro f? uilding height measurement usually not to exceed 25 feet) Yes ------ 3 15. Does the plan include any stove or zero clcaran place planned for installation including make · ations or phase II EPA certification? Yes ------ 16. Does the plan include a masonry fireplace includi 1replace section indicating design to comply with the !RC? 17. Does the plan include a dow schedule or other verification that egress/rescue windows from sleeping or basements comply with the requirements of the IRC? Yes ------ 18. Does the plan include a window dule or other verification that windows provide natural light and ventilation for all hab · e rooms? Yes ____ ...=,._ @Do the plans indicate the location of glazing subject to human impact such as glass doors, glazing immediately adjacent to oors; glazing adjacent to any surface normally used as a walking surface; sliding gl oars; fixed glass panels; shower doors and tub enclosures and specify safety glazing for th areas? Yes No ------- 20. Is the location of all natural and liquid petroleum gas furnaces, boilers and water heaters indicated on the plan? Yes ------ 21. Do you understand that if are building on a parcel of land created by the exemption process or the , are building plans in compliance with all plat notes and/or covenants? 22. Do you understand that if you belong to a Homeowners Association (HOA), 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 be accepted without it, but you run the risk of the HOA bringing action to enforce the covenants, which can result in revocation of permit issued . Additionally, your Pl an Review fee is not refundable if the plans have been revie ed by the Building Department prior to any action by the HOA that requires either revocatio~ qr s stantial modification of the plans . Yes N ____ ........ _ y residential structure on the parcel? Yes No If no-Explain: _.,.______ ------- 24. Have two (2) ~s of construction drawings been submitted with the application? Yes ------ 4 25. Do you undcrstanrt.tf<afthc minimum dimension a home can be on a lot is 20ft.widc and 20ft. long? Yes ~ --·---- ------ 26 . Have you designed or had this plan designed while considering building and other construction code requirements? ;,..-- Yes ~ ------ 27. Do your plans comply with all zoning rules and regulations in the County related to your properties zone district~ Yes - 28. Does the plan accurately indicate what you intend to construct and what will receive a final inspection by the Garfield CJlH111:'Y1fuilding Department? Yes ~ , ------ 29. Do you understand that approval for design and/or construction changes are required prior to the application of these~ Yes ~ ----=:.-- 30. 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" ~ic System" fees required, at the time you pick up your building permit? Yes~ 31. 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 f~~~ 7:3~ 3:30 p.m. Monday through Friday. Inspections are to be called in to384~~ "\.T. Yes No ------- 32 . Are you aware that requesting inspections on work that is not ready or not accessible will result in a $50.00re-~ Yes ------- 33. Are you aware that you arc 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 C.----------- 5 34. Are you aware that the Pe · Application must be signed by the Owner or a written authority being and that the party responsible for the project must comply with the IRC? 35. Do you understand that you will be required to hire a State of Colorado Licensed Electrician and Plumber to perfonn installations and hookups, unless you as the homeowner arc perfonning the work? The license number of the person perfonning the work will be required at time of applicable inspection. __..----- Yes ~ ~-~----'=---~-- 36. Are you aware, that on the front of the Building Permit Application you will need to fill in the Parcel/Schedule Number for the Jot you are applying for this pcnnit on prior to submittal of a building permit apR · ion? Your attention in this is appreciated . Yes -~-t:.~;..._~--~ 3 7. Do you know that the local fire district may require you to submit plans for their review of fire safety issues? ~ Yes (please check with the building department about this requirement) 38. Do you understand that if you are planning on doing any excavating or grading to the property prior to issua~nnit that you will be required to obtain a grading pennit? Yes ----- 39 . Are you aware that if you will be connecting to a public water and/or sewer system, that the tap fees have to be paid and the connections inspected by the service provider prior to the issuance of a Certificate of Ocr~ Yes ~r----J . ----- 40. If you anticipate obtaining a water tap from the City of Rifle, please provide a letter indicating that the City will provide water service. No building pennit application will be accepted without such ~~:tter.~ _ __,_;==---- Phone: 'j~( OCJ/; (days); r 6 Project Address: ___________________________ _ Notes: If any required infonnation is missing delays in issuing the pennit are to be expected. Work may not proceed without the issuance of a pennit. If it is determined by the Building Official that additional information is necessary to review the application and plans to detcnnine minimum compliance with the adopted codes, the application may be placed behind more recent applications for building pennits in the review process and not reviewed until required infonnation 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. bpminreqsfMar2009 7 GARFIELD COUNTY BUILDING REQUIREMENTS Codes: 2003 IRC, IBC, IFGC, IMC, IPC, 2006 IECC. Setbacks: Check subdivisions and zone district for setback requirements. Snowload (measured at the roof! Not ground): 40PSF up to 7000ft. elevation. Seismic design category: B SOP SF 7001 ft to 8000ft. 75PSF 8001ft to 9000ft. IOOPSF 9001 to lOOOOft. Weathering probability for concrete: Severe. Termite infestation probability: None to slight. Wind speed: 90mph. Decay probability: None Wind Exposure: B orC (see section R30l.2.1.4) Frost Depth: 36in. to 8000ft. elevation. 42in. 8001 and above. Winter Design Temperature: Minus 2 to 7000ft.; minus 16over 7000ft. elevation. Air Freezing Index: 2500deg F-days to 7000ft.; over 7000ft. to be determined by Building official Ice shield under-layment required. Mean Annual temp: Variable Insulation: Windows/doors U=.35, Skylights U=.6, TBL 402. l. l, 2006 IECC. Minimum R-Values: • Ceilings/roofs R values are R-38 stick built structures. R38 log construction and steel rafter construction. • Walls R values are R-19 wood frame; R-19 cavity R-3 sheathing or R-10 sheathing for steel studs. • Floors R-values are R-30 or enough to fill cavity. • Basement wall R-values are R-10 below grade, R-19 above grade. • Slab perimeter R-values and depth is R-l 0/24in • Crawl space wall R-value are R-10 below grade and R-19 above grade. If floors over crawl space are not insulated, the crawl space walls must be insulated. Basement wall must be insulated to frost depth. Common walls garage to house must have R-19 insulation. Common ceiling/floor garage to house must have R-19. Take precautions to protect plumbing in these areas. bpminreqsfMar2009 8 GARFIELD COUNTY DRIVEWAY PERMIT REQUffiEMENTS Information required lly Garfield County Road & Bridge fo1· dl"ivcway permits or exemption letters: > Slatc your request (driveway permits vs. exemption). ):-Lcg:il dcscriptioit; lot & blocl<# preferred, meets & hounds if neecssRry )> Plat 01· sketch, showing driveway locntion nnd any c:iscmcnls (must show nearest County Road and be easily readable). )> Owner of record (ns nppe111·s on the tax-roll). }:> Owner's mailing address, phone, fax (& cell if npplicable). }'> Subconfrnclor (if applicable) with conlact person, address, phone, fax & cell. > Be prepal'cd fo show your property pins/comers. Quick reference guideline for new 01· change of use ddvcways: }> Only one access per p<irccl (unless dcmonsh·atcd need) > 90 degree intcrscclion with County road for first 30 feet }'> 3 % ma1<imum grnde for first 30 feet }'> 4" thick hot asphalt/concrete apron if County road is paved. )> 300 feet visibiiity in both directions )> Corrugated steel culvert if a road ditch is crossed ( 15" min, no plastic or aluminum) )> DrivcwAy rnnoff must not reach County road! > Obtain permit before commencing work, pay fee & sign, keep on site )> Complete the driveway within 30 days of pulling pennit. DO NOT DELA Yi Contact: Road & Bridge Main Office: 0298 CR333A, (Hunter Mesa Rel), Rifle, Co 81650 •• Ph 625·860 I. Office hours al'C 7:00am lo 4:00pm Monday through Friday. The Road & Bridge office will issue the peimit. It can be picked up at the above address, or foxed upon receipt of payment. Payment can be made with a check or credit card. Garfield County Road & Bridge 0298 CR 333A//PO Box 426 Rifle, CO 81650 PH: 970-625-8601 FAX: 970-625-8627 ronclandbl'idge@garficld-county.com Driveway Permit Check Off Form l. Permit Owner: ._I _________________ _, 2. Mailing Address: 3. City: Carbondale 81623 D Gienwood Springs 81601 D New Castle 8164 7 0 Silt 81652 D rune s16so D Parachute 81635 D Other i I 4. Phone No:! FaxNo: I ,. 5. County Rd. No: '--~-----------------' 6. Nearest Intersection or address: C._ ___________ ~ 7. Distance from lnt. or address: 8. Dil'cction from Int. or address: N DEDsD N0E0sD wD 9. Side of road: 10. Width of driveway: 1 l. Culve1t required : 30-foot D 40-foot wD D lOO~foot D Other: ._I __________ __, Yes O No D 12. Size of culvert required: I 2-inch 0 I 5-inch D 18-inch 0 Other: 13. Length of culvert required: 30-foot 0 40-foot Oothe1j l 14. Asphalt or concrete pad required: Yes D No 0 15. Size of pad: 30-foot wide X IO-foot longX4 inches thick: Yes D 40-foot wide X 10-footlong X 4-inches thick: Yes D 100-foot wide X 20-foot long X 4-inches thick: Yes 0 Other:! .... ------------------' 16. Gravel portion required: .Yes 0 17. Length of gravel p011ion: 40-foot D 50-foot 0 100-foot D 18. Trees or brnsh removed for visibility: Yes Q No D 19. Distance and direction from driveway to be removed: 20, Driveway must be no more than 3 % slope away from County road. 21. Drive must be constructed so no drainage accesses County road from driveway. 22. Certified traffic control required: Yes D No D 23. Work zone signage only required: YesO No D 24. Stop sign required at entrance to County Rd. YesO No D 25. Inspection of driveway will required upon completion and must be approved by person issuing permit or representative of person issuing permit. 26. Person Requesting Permit: 27. Person issuing permit: 28. District pennit issued in: 30 29. Date check.list completed:{ .... -~-------------....... BOARD OF COUNTY COMMISSIONERS OF GARFIELD COUNTY CERTIFICATION AND AFFIDAVIT REGARDING ILLEGAL ALIENS 'rhe Contractor, vhose n a me and signature appears belo1·1, certifies and agrees ~s follOl·IS: 1. The Contractor shall co:nply with the provisions of C.R.S. 8-17.5-101 et seq. The Contractor shall not knowingly employ or contract 1-1ith an illegal alien to perform work for the Board of County Commissioners of Gar.field County / Colorado ("BOCC") or enter into a contract with a subcontractor that knowingly employs or contracts with an illegal all.en. 2. The Contractor represents, warrants, and agrees that it has verified that it does not employ any illegal aliens; that it has participated or attempted to participate in the Basic Pilot Employment Verification Progra1~ administered by the Social Security Administration and Department of Homeland Security; and othen1ise shall comply \·lith the requirements of C.R.S. B-17.5-102(2) (b). 3. The Contractor shall comply 1·1i th all r.easonable r 1t quest5 made in the course of an investigation under C.R.S. 8 -17.5-102 by the Co l orado Department of Labor and Employinent. If the Contractor fails to comply with any requirement of t his provision or C.R.S. B-17.5-101 et seq., the BOCC may terminate work for breach and the Contractor shall be liable for actual and consequential damages to the State . . 4. If the Contractor is a sole proprietor, the undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one) ; I am a United States citizen, or r am a Permanent Re sident of the United States, or I am la1·1fully present in the United States pursuant to Federal law. I understand that this s:-iorn statement is required by law because. I am a sole proprietor enteting intd a contract to perform work for the BOCC. I understand that state law requires me to provide proof that J am l a wf ully pr~sen t in the United States prior to starting uork for the BOCC. I further acknowledge that I will comply with t he requirements of C.R.S. 24-76.5 -10! et seq. and will produce the required form of identification prior to starting work. I acknowledge t hat making a false, fictitious, or fraudulent statement or representation in t his s1·1orn a f fidavit is punishable under the criminal laHs of Colorado as perjury in the second degree under C.R.S . 18-B-503. CERTIFIED and AGREED to this day of CONTRACTOR: (Contractor Full Legal Name) By: Signature of Authorize d Re p Jr.111i9ration l\fUda,•it (OB/06) rinal EXHIBIT FEIN or Social Security Numb er T itle HOW TO GET TO THE BUILDING SITE Directions to the site: --------------------- Use the space below to provide a detailed drawing showing the location of your building project. Show all roads and road names leading to the project. Show mileage. Start from Pom;,roy. - ----r--------=I ~o ~...,-le. .;l-4-';)s-c ll 13=!- ~ ~sf", Uf Ct:;1-1j 11~ ( rf#-t>f( ~