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Communlty DevelopmGnt llcparùnGnt
108 Et Strcet, sultc¡101
Glenwood Sprlngs, CO 81601
(97019¡f5{212
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Garfield County
GRADING PERMIT
APPLICATION
E MNoR MINOR
INVOTVED PARNES
PropertyOwncr:
MalllngAddrees:
EmallAddress:
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Contractor:
7qMalllngAddrcss:
EmrllAddrcss¡
MalllngAddrcss:
E¡nall Addrcss:
Archltcc:
Englnecr:
MalllngAddress:
EmallAddrss¡:
AÍ{D IOCATION
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coJob Addrcr¡:
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Assc¡sol'¡ Parccl Number:
Earthwork (square feetf :
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Earthwork (Cublc y¡rdsl: _
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Adùg&. Thls appllcrtlon for s Bulldln¡ Pcrmlt murt bc sl¡ncd by
.n authodred .gcnt. lf thc sltnåtura babw ¡s not thrt qf tha Owncr,
Owner, must bc provldcd with this Applkatlon.
l¡¡rl Acc¡rs. A Building Pcrmlt onnot be lssued wlthor¡t proof of lqrl md adlguôtc accc¡s to thr propcrty for
purposes of inspcctlons by thc Bulldlng Dlvlslon.
Otl¡t Pcrmlts. Muhiplc scparatc permlts may bc rcqulrcdl (lt Statc Electrlc¡l Permlt, (2) County OWIS Pcm¡t,
(3| anothcr permit rcquircd for usG on thc propcrty ldrmlflcd abow, c.t. Strtc or County Hl¡hway/ Ro¡d Aæc¡s or
a State Wastewatcr D¡schartc Pcrmlt.
vold Pcrnlù A Eulldlng Pcrmlt bccomcs null ¡nd vold lf thc work ¡uthorized l¡ not commcYlccd withln 180 days of
the datc of lssuance and lf work ls suspcndcd or obrndoned for a period of 180 dðys tftGr GommcncGrncnt.
thG Officr of thc prcperty, dcscrlbed ¡bovc, or
r sepan¡ta lÉ-ttcr of authorþ si¡nrd by thc
I hercby ccrtify that I havc read thb Appl¡cetlon ¡nd thât thê lnform¡tion contðirìêd .bovc is truc
understand that the Bullding Diúslon ¡ccepts the Applic¡tlon, alon6 with the plans and specillcatlons ¡nd other
data rubmfücd by me or on my bchtlf (submlttals), b¡scd upon my c.rtlflcation es to åccur.cy. Assumln¡
of thls Appllcation, a Euilding Permlt will be igsucd Srtntlnt
the structurd¡l and facllltlcs detallcd on the submittals rwicwed by thc
of the Bulldlng Prmit, I egr€c that I and my ¡Bents wlll comply
regulatln¡ the work and thc Garfleld @unty Eulldlng Code, OwlS
from theQounty, if the locrtlon, constructlon o¡ u¡c of thc structurc(sl
Owncr, I rcknowlefic that rccpomlbillty for complbnce wlth fcderal, stalc and lçal laws and County ßcgulatlons
rest with me tnd my authorizcd agents, includlng wlthout llmitatlon mytrch$cct óesl3ner, englneer and/ or
\,.
¡ndconcct. I
local lev
(County
whh provlsions of any fcd3ral,
Rcgulation(s)). I acknowlcdtc that thc Bulldlng Pcrmltrcgulat¡ons ônd applic¡blc lend udt.
may be suspended or revoked, upon
completcness of thc aubm¡ttab and
pe]miss¡on to me, ¡i Owncr, to
Sullding Olvlslon. ln
ALL UTITITIES MUST BE TOCATED PRIOR TO ANY GRADI]IG
I hÊrcbyr¿ooulctcû¡t I hruc rcrd end úndcr!ûüú thc llotlcc rnd
hrv. prottldGd
¡bovc a¡wcll ¡¡
.rd .e¡rrt. b thr brct of nry lnowhd¡c.
!u^ é)eçz< þl"t l'.
Prop.rty Ouncr Prlnt rnd Sl¡n
¡lil¡r¡{G/ trârúiltilc Dtvtstoil !
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ðuz ø"N<
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tulbc taar¡Toül f.r.l F¡r¡Pad¡
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