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Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701 94s-8212
GRADING PERMIT
APPLICATION
TYPE OF GRADING
É unron tr MINOR
INVOTVED PARTIES
Property Owner:
Mailing Address:
N c Phone:303 7'l -ptl
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EmailAddress:fiaþ¿ & r**ra\l¿r. tòun
Contractor:J fa\,h¿r (ortt )¡¡t't Phone t41o tStv-0Øq
oMailing Address:
EmailAddress:
Architect:Phone: I I
Mailing Address:
Email Address:
Engineer:ü¡ Pa la"/ 1n (Phone: ú10 t6ef._ -A4 +V
Mailing Address:
EmailAddress:
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PROJECT NAME AND LOCATION
Project Name Ro b,ns¿n l-þuv¿
Describe Work Ë>r ta ,rÀI[^n hr fnm.l"l Id/a
Job Address:Â
Assessor's Parcel Number:
Sub.rot A tf Block
Earthwork (square feet):Earthwork (Cubic Yards):6+6
Author¡tv. This application for a Building Permit must be signed by the Owner
anauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedbythe
Owner, must be provided with this Application.
Lesal Access. A Building Perm¡t cannot be issued w¡thout 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 Perm¡t 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.
of the property, described above, or
I hereby certify that I have read this Application and that the i
understand that the Building Division accepts the Application,
data subm¡tted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Building Permit will be issued granting
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 ¡n 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 Offícial from: (1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction
or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law.
Review of this Application, including submittals, and inspections of the work by the Building Division do not
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies' As the
owner, I acknowledge that responsib¡lity for compliance with federal, state and local laws and County Regulations
rest with me and my authorized agents, including without limitation my architect designer, engineer and/ or
builder
nformation contained above is true and correct. I
along with the plans and spec¡fications and other
CERTIFICATION
ALL UTITIT¡ES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have p rovided the required information which is correct and accurate to the best of my knowledge.
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DateSign
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OFFICIAT USE ONIY
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Fees Paid:
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Totãl Fees:
00. 0aM¡sc Fees:Perm¡t Fee:00
Zoning:
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Grading Perrnit:
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Balance due:
BUILDING / PLANNING DIVISION :
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Date
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