HomeMy WebLinkAbout3561-~1
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GARFIELD COUNTY
BUILDING, SANITATION and PLANNING DEPARTMENT
109 8th'S1reet Suite 303
Glenwood Sprlng11 Color11do 81801
(303) 945-9212
0121 ~ton, Rifle Village SOuth Metro, Rifle, CO JobAddress ------~--~-~------~~-----~----'--------------
Nature of Work Pennit
Use of Building ---=~l<:>lfl----------------,-----------------,-------
Contractor ___ __.,.._u;_ _____________ ~---------------------~-
Amount of Permit: $ _ __.2'""5"' _ _..0 .. 0'---"p_....nn...,, .. j...,t ____ _
White .-.'Treas.
Canary-Office
Pink· Applicant
Gold -Duplicate
16,25 Plan Check
41.25 TOtal
Date: 6/27/BB
E. Haring
Clerk
, GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT ,.
\
please print or type
PERMIT NUMBER ------
DATE ----------
FILING# ___ _ LOT #
TAX SCHEDULE #
LEGAL (SEC/TWN/RNG)
"' 'NAME .:;;:="e f7 ! ~ ADDRESS ---------------;;! CITY ~ IPHONE-_-_-_-_-_-_-_-_-_-_-_-_-LICENSE #
CLASS OF WORK
NEW ALTERATION X ADDITION ----
DEMOLISH REPAIR MOVE ------MOBILE HOME (make/model) ..--
s ,F. OF BUILDING ;ztt A,-;f----;;-s:.FP-.-rol<p;--;:'LO;::;:T-;;--:===-
# OF FLOORS ( 'HEIGHT G r"tfi
# OF FAMILY UNITS { # 0 BEDROOMS -===--
INTENDED USE OF BUILDING ~~~~~~~~~:J--'.~?L_,
GARAGE: SINGLE_ DBL
FIREPLACE
WATER SUPPLY y,~~-fJ. c<bi P,ittt
DRIVEWAY PERMIT J
SITE PLAN 1J o Cb "1" 9 .e ,t,_, "!fef ba.+-k>
BUILDING PLANS
SANITARY SEWER CC~LE~A~R~A~N~C~Es:~~~~~~~========~ ON SITE SEWAGE DISPOSAL PERMIT
OTHER DOCUMENTS (specify)
PLOT PLAN
NOTE: Show easements, property line dimensions,
all other structures, specify north, and street
name. For odd shaped lots, or if space is
too smal.1, provide separate plot plan.
# OF BUILDINGS NOW ON PARCEL -~C).:.L,n.L.>.e~---
USE OF BUILDINGj NOW ON PARCEL --------
rl' c fcLr
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FRONT PROPERTY LINE
sTREET NAHE/RoAD NUMBER R€tn1A.16 rol\/
a nowledge th t I have read this
application and the above is correct and I
agree to comply all county ordin<lnces
laws ting building construction.
FOR OFFICE USE ONLY
VALUATION
PERMIT FEE $ )..s--..90 PLAN CHECK FEE ,z.$~'¥-7"'-':";<;r
TOTAL FEE $ 4=f, z..,r
DATE PERNIT ~UED ___ _,,._~~-------
ZONING DISTRICT ~~.!.%>~~
TYPE OF OCCUPANCY ~~ ___ _.,......,._~--------
TYPE OF CONSTRUCTION tz,.-I\/
S.F. OF BUILDING e4i'£)is.F. OF LOT'-
MAX. HEIGHT ----~ ROAD CLASS. G~b
SETBACKS FROM PROPERTY LINE: FRONT ~r)"Tz'lt e,
REAR RIGHT LEFT __::·==.,,/...!
OFF STREET PARKING SPACES REQUIRED ______ _
ADDITIONAL INFORMATION NEEDED
~--~~~~-
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER ....;..--~~~------~-~--
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