HomeMy WebLinkAboutApplication- PermitJob Address
Nature of Work
Use of Building
BUILDING,
No. 6030
GARFIELD COUMY
SANITATION and PLANNING DEPARTMENT
109 811i Street Shite 303
Glenwood Springs, Colorado 81601
(303) 945-8212
Blue Heron Lane, Carbondale
Building Permit
Employee Housing
Owner Robert Nieslanik
Contractor Scott Nieslanik
Amount of Permit 98.18 Date August 16, 1996
Permit: 59.50
Plan : 38.68
Paid $38.687-19-96
S. Archuleta
Clerk
CAVA/ 4 2
BUILDING PERMIT APPLICATION
GARFIELD COUNTY, COLORADO
Applicant to complete numbered spaces only. PERMIT NO. 40 3C) PARCEUSCHED NO.
Joa ADDRESS
1
LEGAL
DESCR.
LOT NO. 2
SEC iYo7J 3
eLeeK
SUBDIVISION
2
OWNER Re /4 r lViE t.l A!!�C
ADDREss 0823 RD IIS C,!lRjWWI E
PH943-1933
WK PH.
3
CONTRACTOR SCDTT VrES(,AArt
ADDRESS o j•60 ILS' CI%gico/DAtE
PH 9L3-/I3I
LICENSE NO.
4
ARCHITECT OR DESIGNER
ADDRESS
PH.
LICENSE NO.
5
ENGINEER
ADDRESS
PH.
LICENSE NO.
6
S.F OF BUILDING
S.F OE LOT
HEIGHT
NO. OF FLOORS
7
USE OF BUILDING
8
CLASS OF WORK',
❑ NEW ADDITION ❑ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9
DESCRIBE WORK: r4pp At di -el" A 2e ' D " 5Nao5+j pace# Ti BRIAJ6 I ASW lip ? /97g ecQe
10 GARAGE SINGLE DOUBLE
CARPORT SINGLE
DOUBLE
DRIVEWAY PERMIT ON SITE SEWAGE DISPOSAL PERMIT
SITE PLAN
11
VALUATION OF WORK: $
ADJUSTED VAL$ J it V 9 /
PLAN CHECK FEE
SPECIAL CONDITIONS:
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK CR CONSTRUCTION AUTHORIZED IS
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK I5 SUSPENDED
OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW
THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES
GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH 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 LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF
CONST' CTI'o
Date
s
Signature o r, Contractor oraaut prized a • ent a •,- toad notice above.
h r=- •
Building Department Approved e anning Depa en + .. nvalldate
U rf�15"-
SCHOOL IMPACT FEE ifiif
TOTAL FEE/7)5
WATER SUPPLY
PERMIT FEE s.rq' till
NO. OF BUILDINGS ON
PARCEL
USE OF BUILDINGS NOW ON
PARCEL
OCG. GR.
CCNST.TYPE
DATE PERMIT ISSUED 2? -/.6 —!
SPECIAL APPROVALS
REQUIRED
RECEIVED
Nor REOUIREn
ZONING
HEALTH DEPT,
FIRE DEPT.
SOIL REPORT
SETBACKS
FLOOD HAZARD
MANUF. HOME
OTHER
AGR EEMENT
PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO
CONSTRUCT THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT
IN CONSIDERATION OF THE ISSUANCE 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 COMPLIED WITH IN THE LOCATION, ERECTION, CONSTRUCTION AND USE OF
THE ABOVE DESCRIBED STRUCTURE. THE PERMIT MAY THEN BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT
SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMIT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM
THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING
OPERATION BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS
JURISDICTION.
THE REVIEW OF THE SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN
ACCEPTANCE OF ANY RESPONSIBILITIES OR LIABILITIES BY GARFIELD COUNTY FOR ERRORS, OMISSIONS OR DISCREPANCIES. THE
RESPONSIBILITY FOR THESE ITEMS AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICALLY WITH THE ARCHITECT, DESIGNER,
BUILDER AND OWNER. COMMENTS ARE INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST.
Garform,003 I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL 1
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