HomeMy WebLinkAboutApplicationtmÌ{l{Ë0
REC EIVEff mmunity Development Department
108 8th Street, Suite 401
AUG 1 5 2018 Glenwood springs, co 81601
GARFTELD COUN] p70le4s-82t2
COMMUNIÏYO'U"O"'I,,YW
TYPE OF GRADING
wlruon 1l MINOR
Gurfield County
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INVOLVED PARTIES
Property Owner:
Mailing Address:n
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Contractor:?-¿, tttlAllr,rs - Wa tk
Mailing Address:I
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Phone: 31()t aF+5- 1U tz
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EmailAddress:wa (
Architect:Ørvcr- ßar ln
(Mailing Address:
EmailAddress:
Engineer:v
Mailing Address:
EmailAddress:
PROJECT NAME AND LOCATION
Project
Describe Work:X
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Job Address:C\ù
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Earthwork (Cubic Yards):35Ò
Assessol's Parcel Number -nv--0
Sub.S+eele Svb r/r 9ion Lot L Block
i Earthwork (square feet):
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
-À"iñr¡W. ff iiãpóiiiàiiıñ f"i ieuitd¡ne Permlf muri be signed by the Owner of the property, described above, or
,anauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedbythe
' Owner, must be provided with this Application.
, Leeal Access. A Building Permit cannot be issued without proof of legal and adequate access to the propefi for
I purposes of inspections by the Building Division.' Other permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
, (3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permlt.
Void permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
' the 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 i nformation contained above is true and correct. I
understand that the Building Division accepts the Application, along with the plans and specifications and other
I data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
, completene5softhesubmittalsandapproval ofthisApplication,aBuildingPermitwill beissuedgranting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Division. ln consideration of the issuance of the Building Permit, I agree that I and my agents will comply
, with provisions of any federal, state or local law regulating the work and the Garfield County Building Code, OWTS
regulations 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 inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: {1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construct¡on
or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law.
'ReviewofthisApplication,includingsubmittals,andinspectionsoftheworkbytheBuildingDivisiondonot
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the
Owner, I acknowledge that responsibility for compliance with federal, state and local laws and County Regulations
: rest with me and my authorized agents, lncluding without limitation rny architect desigtrer, engineer and/ or
builder
I hereby acknow¡edge that I have read and understand the Not¡ce and Certificat¡on above as well as
is correct and accurate to the best of my knowledge.
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Owner and s¡
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OFFICIAT USE ONLY
Special Conditions:
Grading and excavation at Owner's risk pending building permit review/approval. Prior to review and
issuance of building permit, Owner shall prepare and submit the following: (A) site specific soils report;
(B) septic system design; and (C) site grading and drainage plan - all prepared and certified by Colorado
licensed Professional Engineer.
Permit Fee: .,
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Misc Fees:r\/R 'HiÅ"ñ.0Ò Fees Paid:
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B¡lance duel
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Grading Érmit:
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lssue Date:Ffal tR
zoñ¡ng:L
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BUILDING / PLANNING DIVISION :6lØlzotø
Signed Date
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