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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue
Glenwood Springs, Colorado 81601
(308) 945.8241 / (303) 625.3321
Job Address CO (� R17ad 64 2 mi West of iti f1 e
Nature of work g ildin . Pearmi for mobile home ranted bY Special Use Permit
Use of Building Sin l e fam"Y dwelling
Owner Mountain Fuel Resources
Contractor Jerry Baysinger .
Amount of Permit: $ 128.50 July 8.1983
Date: _.
School Impact Fee Paid Ellen L. Hicks, Clerk
under Special Use Permit
application
IRJ
ILDING PERMIT APPLICATIO
GARFIELD COUNTY BUILDING DEPARTMENT
Owner: V1, fl 41 /, z /
Contractor or Builder:
Location
Purpose for which building is to be used
Size of Lot; ` -" 19,-,
Distance of building from property line at
14=�,,
Front: Rear:
_40 -11 -
Distance from nearest building: 171717
Source of water supply: 0' 0 ' 7 7,_
Type of sewage disposal; 71
Width of building:
Length of building: — [�
Height of walls:
Floor space in square feet: �L"
Estimated value: $
Date construction will begin:
Permit charge: $=�
Plan check fee: $
TOTAL: $
Garfield County, Colorado,
Address : z Phone.
Left Side: Right Side
Number of stories: /
Number of rooms: 5
Type of foundation: p h a a
Material in outside walls:
Exterior finish:
Type of roof:
Date of completion:
adjAnd I/We hereby agree to build strictly to the terms of the above description, and also to clear the grounds and
acent street or streets of all rubbish and debris caused by the construction of said building.
Respectfully,
NOTE:If you are constructing a dwelling on a building site established by subdivision
or by SB 35 exemption prior to April 20, 1981 or if the parcel of land is more than 35 acresCeyou
may be subject to assessment of a $200.00 School Impact Fee prior to the issuance of a building
Permit, as provided in Garfield County Resolution 81-263 adopted as an amendment to the building
code. (see attached)
The County Corninissioners hereby grant the above perinit as
per terms therein stated. This
day of
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