HomeMy WebLinkAboutApplicationGørfield County
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Community Development Department
ED 108 8th street, Suite 401
Glenwood Springs, CO 81601
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INVOLVED PARTIES
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EmailAddress:
Property Owner:
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PROJECT NAME AND TOCATION
Job Address:
Block
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Project Name
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ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Authority. This application for a Building Permit must be sign
an authorized agent. lf the signature below is not that of the
ed by the Owner of the property, described above, or
Owner, a separate letter of authority, signed by the
Owner, must be provided with this Application.
Lesal Access. A Building permit cannot be issued without proof of legal and adequate access to the property for
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 Permit.
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 ac knowledge that I have read and understan d the Not¡ce and Certification above as well as
have provided the required information which is correct and accurate to the best of my knowledge.
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OFFICIAL USE ONLY
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Fees Paid:Total Fees
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Misc Fees:Permit Fee:
Zoninglssue Da!C:Grading PermitBalance due:
BUILDING / PLANNING DIVISION 2
Date
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