HomeMy WebLinkAboutApplicationGurfield Counfii
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970le4s-82t2
www.garfield-countv.com
OF GRADING
AJOR
INVOLVED PARTIES
Property Owner:
Mailing Address:
EmailAddress:I
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Phone ,tol70ì 33 I.3AJt
Phone
Phone:I
Contractor:
Mailing Address
EmailAddress:
Architect:
Mailing Address
EmailAddress:
Engineer:
Mailing Address
EmailAddress:
PROJECT NAME AND LOCATION
Project Name
Describe Work:
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2_Job Address:
Assessor's Parcel Number 7\Ç¡i*q - o'Ìr- 0Õ3
suu. ofi-Sm'r-l1n 3Lot _Block
Earthwork (square feet):tfr.Earthwork (Cubic Yards):
ALL UTILITIES MUST BE TOCATED PRIOR TO ANY GRADING
Authoritv.This application for a Building perm it must be
NOTICE
an authorized agent. lf the signature below is not that of
signed by the owner of the prof ert¡a ¿éi.i¡¡"J ãboue, or"
the Owner, a separate letter of authority, signed by theOwner, must be provided with this Application
legal Access' A Building Permit cannot be issued without proof of legal and adequate access to the property forpurposes of inspections by the Building Division.
9ther Permits. Multiple separate permits may be required: (1) state Electrical permit, {2) county owTg permit,(3) another permit required for use on the property identified above, e.g. state or county Highway/ Road Acccss ora State Wastewater Discharge permit.
Void Permit' A Building Permit becomes null and void if the work authorizecl is not commenced within 1g0 days ofthe date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true and correct. Iunderstand that the Building Division accepts the Application, along with the plans and specifications and otherdata submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assumingcompleteness of the submittals and approval of this Application, a Building permit will be issued grantingpermission to me, as owner, to construct the structure(s) and facilities detailed on the submittals reviewed by theBuilding Division. ln consideration of the issuance of the Building permit, I agree that I and my agents will complywith provisions of any federal, state or local law regulating the work and the Garfield County Building Code, oWTSregulations and applicable land use regulations (county Regulation(s)). I acknowledge that the Building permit
may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s)and facility(ies), described above, are not in compliance with county Regulation(s) or any other applicable law.I hereby grant permission to the Building Division to enter the property, described above, to ¡nspect the work. Ifurther acknowledge that the issuance of the Bu¡lding Permit does not'prevent the Building official from: (L)requiring the correction of errors in the submittals, if any, discovered after issuance ; or 12) stopping constructionor use of the structure(s) or facility(ies) if such is in violation of county Regulation(s) or any other applicable law.Review of this Application, including submittals, and inspections of the work by the Building Division do notconstitute an acceptance of responsibility or liability by the county of errors, omissions or discrepancies. As theowner, I acknowledge that responsibility for compliance with federal, state and local laws and county Regulationsrest with me and my authorized agents, including without limitation my architect designer, engineer and/ orbuilder.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the information which is correct and accurate to the best of my knowledge.
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Property Owner pr¡nt and S¡gn Date
OFFICIAT USE ONLY
Special Conditions:ßt4EtMg ,s¿
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Perm¡t Fee: $\OO Misc Fees:Total Fees:Glo¿:Fees Paid:&tooBalance due:+1a8
Grading Permit:
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Zoning:(L
BUILDING / PTANNING DIVISION :0v(L{K
Signed Approval Date
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