HomeMy WebLinkAboutApplication- PermitGARFIELD COUNTY
BUILDING, SANITATION and PLANNING DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
(303) 895.8212
Job Address 9504 TMy 113 017;b9add,le
Nature of Work Pin] l (1' J D.ermit
Use of Building t taCIled
Owner
Ed Hendricks
04029
yaraye
Contractor Gwrr°r
Amount of Permit: $ 94.20 Date: 1147/4n
Permit 56,.50
Plan 37.70
B. Caytaxxi
White - Treas.
Canary -Office
Pink - Applicant
Gold - Duplicate
Clerk
CC
a
GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
please print or type
TO BE FILLED OUT BY APPLICANT
ADDRESS 2
SUBDIVISION
: .. ;r t ,y
FILING #
TAX SCHEDULE #
LEGAL (SEC/TWW/RNG)
LOT #
BLOCK #
NAME
MAILING ADDRESS
CITY
NAME
ADDRESS
CITY
NAME Cdtag2 112i
ADDRESS
CITY
PHONE LICENSE #
CLASS OF WORK
NEW t/ ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make/model)
S.F. OF BUILDING S.F. OF LOT
# OF FLOORS HEIGHT
# OF FAMILY UNITS # OF BEDROOMS
INTENDED USE OF BUILDING
GARAGE: SINGLE_ DBLk(CARPORT: SINGLET DBL _
FIREPLACE
DOCUMEN ATTACHED
WATER SUPPLY -�
DRIVEWAY PERMIT
y p# 'ta r coals,«
SITE PLAN
BUILDING PLANS s
SANITARY SEWER CLEARANCE Ater
ON SITE SEWAGE DISPOSAL PERMIT frterl-, 7
OTHER DOCUMENTS (specify)
VALUATION
PERMIT FEE $
TOTAL FEE $
DATE PERMIT S ED
ZONING DISTRICT
TYPE OF OCCUPANCY
FOR OFFICE
is; 76ry.is, o
co PLAN PLAN CHECK FEE $ C
2-0 SCHOOL IMPACT FEE $
TYPE OF CONSTRUCTION
S.F. OF BUILDING /2 S.F. OF LOTMAX. HEIGHT re.-�,_ y / ROAD CLASS.
SETBACKS FROM PROPERTY LINE: FRONT
REAR RIGHT 'LE
FF STREET PARKING SPACES REQUIRED
ROVED:
PERMIT NUMBER
DATE ;3/7
PLOT PLAN
6 29
NOTE: Show easements, property line dimensions,
all other structures, specify north, and street
name. For odd shaped lots, or if space is
too small, provide separate plot plan.
# OF BUILDINGS NOW ON PARCEL C' Y1 f
USE OF BUILDINGS N W ON PARCEL
Pes,`c fits,
FRONT PROPERTY LINE
STREET NAME/ROAD NUMBER /33
CHECK IF CORNER LOT
DESCRIPTION OF WORK PLANER
),.AE tt) P - -N\rt-'deb iZ a'
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I hereby acknowledge that I have read this
application and the above is correct and I
agree to comply with all county ordinances
d state laws regulat,ng ding construction.
SIGNATURE
USE ONLY
FLOOD HAZARD
CERTIFIED BLDG ELEVATION
SPECIAL CONDITIONS
PROBLEMS WITH PERMIT
ADDITIONAL INFORMATION NEEDED
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER
PLANNING DEP TMENT
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I hereby certify that this Improvement Location Certi- SE car.. 3 T 85.
ficate of the parcel of land shown hereon was prepared ya.88w, GV.pM.
by me under my direct supervision, that it is not a o
land survey plat or'improvement survey plat, and that it is not to be
relied upon for the establishment of fence, building or other future
improvement lines.
1 further certify that the, improvements on the parcel shown. above
on this date, 3 May 1983, except utility connections, are entirely
within the boundaries of the parcel, except as shown, that there are
no encroachments upon the described premises by improvements on any
adjoining premises, except as indicated, and that thereis no apparent
evidence or sign of any easement crossing or burdening any part of
said p-rcel, except as noted.
Byi
y.' ey Rincicome L.S. 14111