HomeMy WebLinkAboutApplicationGørfield County
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601': (970194s-8212
www.Farfield-cou ntv.com
TYPE OF GRADING
tr MAJOR F MtNoR
INVOTVED PARTIES
Property Owner:
Mailing Address:
EmailAddress:
ß.".*# - t-.,ùn + Kaîa'burn¿-Phone:- 5117c,
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Contractor:e^t+ þb Phone:72Ð 317 -
Mailing Address:
EmailAddress:
3,328b T^,o (2.*.Bar*tS b àtlaLl
e.-,?' (ã a,ra¿>,n tri ll . n'.{-
Architect:G-*" ^ l,*, Aro[ìþ.{t Phone: t1'to ¡\aq - LoL3
Mailing Address (tÇ At q# S{ #,ç ¿"""LIo rô I tb 21
Emaif Address: S novy@. gceþl\\tq-arch,T<" k,cøu
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Ensineer: \l.rr4e \ Assoc" \rt..Phone:(qlo ) qlS- U3oS
Mailing Address:
EmailAddress:
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PROJECT N AN D TOCATION
Project N i +{^
Desribe Work:
/e
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JobAddress, LÐ) 22. S*,.t,Åo Q,orl.h . ç"r{"tJ C,..r^}." C-ô
Assessol's Parcel Number: eb s.2 |,or,2 To-*
Sub..l lot 9l. _Block ""¿e- %'1
Earthwork (square feet) :
PUD
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Earthwork (Cubic Yards):,r50
AI-I. UTILITIËS íUUST ß[ LTCATTÞ PRIOR TO ANY €RANING
NOTICE
å*!þqfi!ï. This *pplicatìcn ior a Building Ferrn¡! mr¡rt be sig**d by rlre Olv*er *f rhe propeny, descrihed above, or
;lnau¡ho:'ireda8Ënl, lf the lignati:tebelowis$o¡tilatofthe{¡rv¡er,alrpârãt*let¡€rof âr¡thority,signedbylhe
ûrvner. muçt be pravide ti wirtr thil Åpplìcetion.
Leeal Âççe¡s. Å åi.;itding Per.ììit c*r{ìal bE i:x.¡ed',,;ìthout proai of legai ar:d adrr¡i.raie êtc*:j to lhs properiy lot
lurpÐsûr of inspectìons by the Buileiing Divilion.
Othetfg¡r¡.l!¡, tulultiple separåìe perrnit: nray Þe requíred: {1) 5tate Êlecrric¡i Permit, {2} County OWTS permit,
l3i acother permil requlred lur ilst on the properb/ identified above, e.g. Stiìie or County ltighway/ Road Access or
ð ståf* Wåstewate r Discharge Pernril.
i/.g'd Fer{!!!. A tuiiding Permit beconres null and voìd if the work authori¿ed iç not comrnenced within L80 days of
lâe d¡te ol issua¡lce and if work i: susprnded or rbancir¡ned f*r a period r:f 180 d*ys aTter conrmcnce ment.
, CEfiïIFITÂTION
i l:ereby cefi¡fY thêl I have read this Appl¡catiûn and that thc information cÕntained above is true äûd correct. I
understand thût th€ Buildin6 Divì:ion åccepts rlie,{ppiicaiion, along lvith the pians ünd tpecificatìons and other
d¡tê stbm¡ltÊd by rne or cn rny behaif (sul¡nìitais), based upon nry cedification ês tr itccurðcy. Assunring
cornpieTe*e:s of the submitt¿is and aoproval oí this Application, a Building Permit will be ì¡sued grðrlting
pernlissisn to rrc, as Owner, to constÍuct the siructr.rre{si and i¡ciliiies detaileel ûn the rubmittals reviernied by the
$uiiding Ðivision. ln considei¿tion of the issuance oí tlre Suilding Pe¡nì!, I agree th;t I ancl my agent: will compiy
with provisions of any fecleral, s¡ðte oÍ locsl lar,v regulating the work and the Garfield County Buildin6 Code, OWTS
regulations and applicable land use regulôtioni {Cor:nty ßegulatìon(s)). I acknowledge that the Building Perrnit
may be srispended or revçked, upon notice fmrê lhe County, if the location, con5trlrction $r use of Ìhe structure {s}
and facilityiies), described above. are nùt in corrpJiance w¡th Co{¡nty Regulation(s} or any othe r applicable law,
iherebygrantpermissiontotheSuildingDivisìontoentertheproperty.¡lescrÌbedabove,ìoinspectthewcrk, I
iurti:sr eckncrvled6e thal the ìssunnce of thc Building Fçrmit does not preverìt the ßuìldir¡g üfficial lrom: (L!
requir'ìng the correction of erors in the subnìittûls, if any, discovered alter issuance; or {?) stopping constrilction
rr üse Õl The structure{s} ur facility{ies} il suçh ts in viqlat¡on of Ctunty Regulation{s} or åny other appllcable law.
Review af this Application, including submittals, and inspections of ìhe rvork by the Euilding Divìsion do not
cûnst¡tute an ac(eptðnc* of responsibilìty cr liabìlity by the County ûf trrors, omissions or cliscrepancies. As the
ûwner. I acknowledge thåt rÊsporìsibility for conpliaûce w¡th feder¡l, stðte and local laws and County Regulations
!.est víith mÊ ãnd rì'ry åuthorì¿ed ôge nts, ¡nçlud¡ng ivithout limitatiûn my architect designer, engirreer and/ or
builder.
t hereby acknowledge that I have reâd ånd understand th€ ruÐtice and C€rt¡f¡ffition above as well as
have requr
Property Owner Pr¡nt and S¡gn
$Fr¡clÂt usE ûI\JLY
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rryþic[je'correct and accurate to the best ol rny knawledge
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