HomeMy WebLinkAboutVoided ApplicationGørfteld {CIwrcfii
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TYPE OF GRADING
tr MAJOR
INVOLVED PARTIES
Property Owner:
Mailing Address:
EmailAddress:
CMH Homes
Contractor:
671 23 Rd, Grand Junction,C
Mailing Address
EmailAddress:richard.ruse@cla n m
David Rasmussen
Architect:
345 o o #207,
Mailing Address
EmailAddress:
yurtstead omail-
nt
. E MINOR
CMH Homes
671 23 Rd, Grand Junction, CO 81505
richard.ruse@cla onhomes.co
(970)
Phone: (' ' )
2 39
245-9039
((e70) )
236-2677
435)
outh, S Ver1,
Phone:
B4O7B
ngl ng.com
PROJECT NAME A
Project Name +t1
Describe Earth work WI e done for the foundations, p art of the "road
1 0
ale, COn
n tng
Mailing Address:
Civco Engi
Engineer:
1256
EmailAddress:
TION
that is affiliated with this artlcular lot, fill, retainin walls
,ç a
a <ì t
Job Address TBD Mounìian Shaáows D nve/enwor:d Springs, CO 81601
Assesso/s Parcel Number 21 19343 o4
sub. Mountain Shadow Place Lot Lot 3 Block
Earthwork (square feet) :
10,000 sqft Earthworl< (Cubic Yards):
2,200 yd3
ALt UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICË
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,clãscribèd above, or
an authorized agent. lf the s¡gnature below is not that of the Owner, a separate letter of authority, signcd by the
Owner, must be provided with this Applìcation.
Legal Access. ABuildingPermitcannotbeissuedwithoutproof of legal andadequateaccesstothepropertyfor
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 Dìscharge Permit.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinLSgdaysof
the date of issuance and if worl< is suspended or abandoned for a period of L80 days after commencement.
CERTIFICATION
I hereby ccrtify that I have rea$this Applicatiorr and that the in[r¡rrnation contained above is true and correct. I
understa¡rd that the Buildirrg ilvision accepts the Application, along with the plans and specifications and other
data submitted by me or on my'behall (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittås and âppr:oval of this Application, a Building Permit will be issued granting
permission to me, as Owner, to construct the structure(s) ancl facilities detailed on the submittals reviewed bythe
Building Division. ln considcration öf the i:sufÀcc of,the Build¡ng perrrrit, I agree LhaL I and rlly agents wlll comply
with provisions of any federal, state or tc)'ðäùardregulating the worl< and the Garfield County Building Code, OWTS
regulations arrd applicable land use reguiations (County fiegulation(s)). I acknowledge that the Buildíng permit
may be suspended or revol<ed, upo¡ notice from the County¡ if the location, construction or use of the structure(s)
and facility(ies), describerJ abo.vË, are not in compliancè witi County Regulation(s) or any other applícable law.
lherebygratrtpettrrissiorr tqflreiBuildìngDivisiont'oentertheproperty,describedabove,toinspectthework.
I
further acl<nowledge that thsjsiqapce of the duilding Permít does not prevenr the Builcling Official from: (1)
requiring the correction of erròrq-ìTçþe submittals, if any, discovered aftel issuance; or (2) stopping construct¡on
or use of the structure(s) or faciliúiff,ç¡i"ff euçh is in violation of Çgpnty.Regulation(s) or any other applicable law.
Review of this Application, including spbmitfals, and inspections óf the worl< by the Building Division do not
const¡tuteanacceptanceof responsibilftir,ðrtijti[tyO¡theCountyoþrroîs,omissionsúrjiscrepancies. Asthe
Owner, I acknowledge thaL responsibility for compJåá?fte with federal,'state i¡rm¡local laws and County Regulations
rest with me and my authorized agents, inclurJiçf,wrthout limitation my architecf designer, engineer and/ or
builder.
I hereby acknowledge that I have reacl and understand .the Notice andrcerti
ded the required information which is uratc to
rty Owner Print and Sign .. Date
na bove as well as
the best of my knowledge.
12/17 /18
OFFICIAL USE ONLY
+oBuiSï
Special €onditions:
\hìòô-
Permit Fee:
O .DO
Mis Fees:Total Fccs
OD.DD
fees Paid:
00 OD
Balance due Grading Permit:
- 5 5"11
lssue Date:Zoning:
K\4
BUITDING / PLANNING DIVISION
Signed Approval Date
b t Do, otc,oßll0417 tv ll