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HomeMy WebLinkAboutApplication-1Vf~Il ' ..._\p~ .._,,; I 4 O>mmunity Development Department f·.AY l 4 ZO 108 ff1' Sreet. SJite401 GARFIELD SOUN fY Genwood ~rings. 0081601 r 'MUNI 1 Y :-i-FLOP\~E~ 1 (970) 945-8212 www .garfield-county .rom TIF£0F~ING D MAffi INVa...VBJ PARTIES ~Ml~ A"opertyONner: 15+1 t:'\duc tlLvec.J.: ,LLC... Alone:AJo >QLf5-91 S7 D MailingAddress: t6Y..t C-h.1 l?d\3Z C\k nLtXLc l S pi.)~. 1 to ~/~01 Omtrac:tor. L\Vc L 1,,I BLk.lru: ~~ °Tl1 k Rlone: c0l7o > q8t( -d-i03 / MailingAddress: e lil ~t 3GZ: ~lU Ca c+LL,C £) s·11uy.-, L)(?~ie.. 3 ici-5 1$2 Archited: _______________ Alone: ("-_-1>_ ----- MailingAddress: _____________________ _ E'lgineer: _______________ Alone:"-( _-1>_ ----- MailingAddress: _____________________ _ ~NAMEANDLOCAllON A"ojed Nane: I J.Q d±l< :1 .1 Kt sl ct'c r'l u.... DesaibeWork: Vrf-4 '.Xt 4s :ilk +ui.-s U1Cj.k < l:i ··-tl 41.;.j ee~1 rt1 q <:L Assessor's Parcel Number: ;b I l CJ -~ 3 4 -0 0-0 ¢i I SJb. ____________ lDt ____ _ Bock ____ _ farthwork (square feet):-------Earthwork (OJbicYards): _____ _ All. UllUllE5 M usr BELOCA lID ~ORTO ANY ffiADING Nan CE Authority. lRs application for a EUl<ing Fennit musl be sigled by the ONner of the property. de!Iribed above, a al authorized agent. If the Signaure below is not that of the ONner, a separate letter of arthority. sigied by the ONner. must beproWjedwrththisftpplication. legal fll::D:ss. A anlding Permit cannot be issued without proof of legal and cmequate acr.ess to the property for purposes of inspections by the Blikfmg Dvision. Oher Permits. Multiple separate permits may be req\jred: (1) Sate Bedrica A!rmit. (2) O:nmty ls:lSAlrrnit. (3) aiother permt required for use on the property identified above. e.g. Sate or O>Unty ~ Rm Jta:ess or a Sate wastewater Clsdlarge Pemit. Void A!rmit. ASJilcing A!rmit becomes null and void if the work adhori2!!d is not con1nena!d within 180 days of the dale of i$uanoe ald if work is suspended or asxloned for a period of 180 days after corrmencement CBmR~llON I hereby a!rtifythal I have real thisApplication end that the information cxmtained above is true ald mrred. I underSand that the llilding llllision 3CQ!Pls the ftfJplic:ation. along with the plats and specifications iB1d other data SJbrritted by me or on my behaf (subrmtas), based upon mJ oertificaion as to a:xuacy. Assurring cx:rnpleteness of the submittals and ~roval of this,6pplication. a llllding A!rmit will be issued gaming pemission to me. as Owner. to mnstruct the strudure(s) ald faalities delaled on the submittals rewiewed by the !biding Dvislcn. In mnsideration of the issualoe of the SJilding R!mit. I <vee that I and my agents will a>mply with provisions of aiyfedercll. state or lcx::al la.v r~aingtheworkClld theGriield O:Junty anlding Olde, JS'.:S regulationscn:t ~!Cable land use r•ations (Cbunty ~ion(s)). I adalowledge that the SJllding A!rmit rr2J be suspended or revoked, upon notice from the Cllunty, if the localion. construction or use of the slrudure(s) a'ld faDlityfies). described above, ae not in cnmpli~with Cl:x.lnty ~ation(s) or aiy other applic:Zle laN. I hereby grant pemission to the a.ilding D\li9on to enter the property, demibed above.. to inspect the wort. I flsther cDnowledge that the~ of the Balding Permit does not prevent the B.lllding Oficiai from: (1) requiring the oorredion of errors in the SJbrritt3s. if aiy, cfiscovered after issuance: or (2) stopping oonsrudion or use of the structure(s) or facility(ies) if sich is in violation of Q)unty ~aion(s) or i!l1'J other appficable law. feliew of this Application. including subnittals, and inspections of the work by the anlding Dvision do not oonstitute an aa:eptaloe of responsibility or li a>tlity by the O>unty of errors. omissions or cisaepancies. As the ONner, I adalowledgethal responsibiUtyfor ~~with federal, state and local la.vscw:I Cbtrty~ations rest with meaxf my a.Jthonzed agents. indudingwithout lirrataion my an:tuted designer, engineer aidf or builder. I hereby acknowledge that I have r~ and understand the Notice and c:Btification above as well as have provided the required information which is oorred and acx:urate to the best of my knowJedge. ~CL~~LJ-= L1sa.9iva.l, (~~ru1 ~u.dd.n*ic.) 5-t~-zott.J. Roperty ONner Aint and Sgn ~e