HomeMy WebLinkAboutVoided ApplicationGør.freld C*unty
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GARFrËLD couNTy Glenwood sp^tllct,co 81601
C0MMUNITY nev¡iopuËruï (970t'94s-8212
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WPE OF GRADING
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INVOLVED PARTIES
CMH Homes
Property Owner:
(970)
Phone: (' ' )
039
671 23 Rd, Grand Junction, CO 81505
Mailing Address
Email Address:richard. ruse@cla on hom es. com
CMH Homes e7o)245-9039
Contractor:
Mailing Address:
EmailAddress:
671 23 Rd, Grand Junction,
richard. ruse@cla onh
David Rasmussen 236-2677
Architect:
Mailing Address:
345 Colorado Ave,
EmailAddress:
yurtstead@gmail.com
(435)
Phone: (: '
)
al, LJT B4o7B
ring.com
PROJECT NAME AN TI
Project Name ountar
Describe arth work WI e done for the foundations, part of the "road
1
ndale,
th, Suite 1,
Civco Engineering,
Engineer:
1256
Mailing Address:
van
EmailAddress:
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that a ffi iated w th this icular lot ,fi reta ¡n ¡n wa lla
JobAddress TBD Mountian Shadows flve/enwoo d Sprinqs, CO 81 ó01
Assessor's Parcel Number:21193432s002
sub. Mountain Shadow Place Lot Lot 2 Block
1 ,1 00vd3Earthwork (square feet). 5,000 sqft Earthwork (Cubic Yards)
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Author¡tv. lhisapplicationtoraBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,or
an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by the
Owner, must be provided with this Application.
Legal Access. ABuildingPermitcannotbeissuedwithoutproof of legal andadequateaccesstothepropertyfor
purposes of inspectiorrs 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.
VoidPe?mit. ABuildingPermitbecomesnullandvoidiftheworl<authorizedisnotcommencedwithinlS0daysof
the date of issuance and if worl< is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
I hereby certify that I have read this Applicatio¡r and that the iniotnaticrn contained above is true and correct. I
unders[arttl tlrat the Building Division accepts the Application, along with the plans and specifications and other
data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Applicatíon, a Building Permit will be issued granting
permission to me, as Owner, to construct th.e,ritructure(s) and facilities detailed on the submittals reviewed by the
Building Division. ln consideration of the isl¡Jance of-the ßuilding Perm¡t, I agree that I ancl tîy agents will cornply
with provisions of any federal, state or toçit"tawlegtlating the work and the Garfield County Building Code, OWTS
rT
rty Owner Print and Sign Date
I
OFFICIAL USE ONLY (-
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Special Conditions
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Permit Fee: ,
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Miçc Fees:Total Fees; .
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Fecs Paid:
loo .oo
Balance due:t:,Ì
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Gradins Permit:
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lssue Date:
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BUILDING / PLANNING DIVISION
Sigrtetl Appr<.rval Date
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