HomeMy WebLinkAboutApplicationGarfield County
2011 Community Development Department
tAN? 11 108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
TYPE OF GRADING
L ❑ MAJOR
INVOLVED PARTIES
GRADING PERMIT
APPLICATION
101 MINOR
Property Owner: K►c,‘\grA nr Mtvr nt ►ricka0.cr s•ays Phone: (3L.;03_) 9ii.,-Ro99
Mailing Address: ,2/.7.R1 Eas4- /'iinena_k ('r•_ A..rocc. CO l L DI [9
Contractor: ' Aonc Ay.„, LV. , t A & Conc rf.Lr a4 Phone: (q70 ) sop-2o2.S
Mailing Address: •R030 C 1ST! GL todoci cpr;r' s Co Rapp I
Architect: ALG, Mat[orel NtS:ren Assoc c- r Phone: ( 2)D) L111-023 1
Mailing Address: ,..2-1K7 SI. I# 1 00 kr a,.c.i OR Ql12 l 0
Engineer: L14U e f Nunn Phone: (97D )2.4-1 090D
Mailing Address: UD 00d Ape.. SL'rV-Vibr1, C.b AtSoi
PROJECT NAME AND LOCATION
Project Name: t ;b trso
Describe Work: c. � .r fin o.r d 5[
k}` rip
Job Address: 1 2.L., ,.r aCAP41
Assessor's Parcel Number: _2195014 070
c1st.
Sub. .ib Lot 70 Mark
Earthwork (square feet): LI. si Earthwork (Cubic Yards): ) 3,c0
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Authority. This application for a Building Permit must be signed by the Owner of the property, described above, 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 this Application.
Legal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required. (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true and correct. 1
understand that the Building Division accepts the Application, along with the plans and specifications and other
data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Building Permit will be issued granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Division In consideration of the issuance of the Building Permit, I agree that land my agents Dill comply
with provisions of any federal, state or local law regulating the work and the Garfield County Building Code, OMITS
regulations and appiicabie land use regulations (County Regulation(s)). I acknowledge that the Building Permit
may be suspended or revoked, upon notice from the County, if the location, construction or use of the structuress)
and facility(ies), described above, are not in compliance with County Reguiation(s) or any other applicable law,
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction
or use of the structures) or facilitv(lesi if such is in violation of County ReEulatinnis) or any nthar apnlirahie lata)
Review of this Application. including submittals, and inspections of the work by the Building Division do not
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the
Owner, I acknowledge that responsibility for compliance with federal, state and local laws and County Regulations
10.04.11 ..IL U• U iuy pUutui l4L.0 06nl lis, ii 1LIUU,a . VVUL, iUUL li,rliLdLluli illy al l.lHL LL 141abl lIC1, +:1 lwllltltl dllU/ Lit
builder.
1 hes•eby acknowledge that i have read and understand the fdotice and Certification above as weii as
have provided the required information which is correct and accu-ate to the best of my knowledge.
OFFICIAL USE ONLY
Special Conditions: n coF i ul`ltoou4 , 7 O Ir4
"Zl U iwt. i'ty4v-y +4.c: rc o A o l: G ter ot,
LIIS 'Piz._ -mitt. GFAiqut,
4442 -IS Rd k 1"1140 1 efar. 1
Pcrn it reg: Misr. Fees:
icit Total FEe : x225 Paid:
IDO .()U `i?D DAD IOD CD
Balance due: Grading Permit: Issue Date: Zoning:
0 C2 ,M2a C —.—qt---il Ria RD
BUILDING / PLANNING DIVISION : a4y
-. - -Provo' Date
Vct 4100 00, if 17//2A1-1 5 01 j(p