HomeMy WebLinkAboutApplicationGarfrcld County
BUILDING PERMIT
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ftffi;Adúe¡s-341 Porderosa titre Glernrood Spnngs Colorab 81601
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oranadtnriær!æpffi" $fthe*pat¡¡rebc{oirbnttffidfheO*ner,aryatekthrda¡tttority'siglrcd bV
tfp ûrrs" rnust be proufuled üi& üús Apí¡¡¡cat¡on-
lÊ4fß¡tfr. A e¡¡fümg Perøn*t ø¡srot be hred wıAßm$¡üpvoo# d leg¡t üd ade$¡ıüe æ üothe popstVfor
prpaees d ¡ñspedic;ts bf the &fl*g Ðiuñi¡¡n.
{tdg,Pcrn*ts, n¿¡*l¡p¡esepd-d¡epsn*lsnrayberq*e*l$ffiÊHeúicilPe'ñnttt2rCoffityOWl5Permit,
(lla¡roürerpernûtreqn¡fudfs useurthe popertyhlentiñed above, eg-State øCøltty H¡gtflray/Road AE€ss
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Vr¡i¡ ncrmit. A ft¡frürg Fennit become¡ nrd ard wrtI if üte wor* a¡rthaized b r¡ot ærnrnenæd nithin 18Û days
gf,flF daæ ofis5l¡ãrre and if usl b s¡¡sperded or ahs¡dsred fur a pefird d il$ dãTs afrer €omtr¡eilcemenL
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I hereby ærtifíúañ ! hãve rødüh¡sAppficıt¡on ar¡dthatthe informatist ænbined abæe blrue and correcL I
umdersbdürattlrcB¡¡ikf,rg DiEäon aqtstf¡eAppfcaüor¡, alo¡gniththe plam ardspeciñcatiotts and other
datas¡bmitted b¡rmeoron r¡f betntr(odbrninalshbæed rryon nryoertification âsto aı¡racy-Assuming
mrnptetmessoflhesrÉrnittab and æproval gür*sAppf,catirry a BrilkfuigFermitüill be ísrcdgrånting
pernriss¡rm to rn€, æ Owner¿ üo cor¡rs¡ructthe st¡¡Åúrrc{s} arld facilities detailcd on t}te sr¡knittals rwíewed bry
tfiekrfldmgDivision. !nmniderationdüreiçsrruedthe erñfürgknlli[ I agreefÛatland r¡Vagetltswill
crnr¡dy wÉt¡ prouôram d any ftdera& Saæ or bcat law regrtrirg üe wk aüd tf¡e GarneH CowtY Bttilditg
Codq"{HfTs¡qld¡¡tursardappf,cabletandusereguhrtfrons(Aorrlr$neg¡datior{sll. ladstotflledgeúatüte
Brffiigpffin¡tnrnybeuryendedorrewkd,upon noiliceftünlñeCsr*V"if ftebcatisl,construcffin trlre
of the sgucn¡rrdd and fåcility{bf[ described abcue" are not in co¡rpínnae with Coünty Regdãtion{s} or any
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!h€f€þygrantpermåssionætfreBuf,rÞgDir*sirrbsfrrtt¡€propertf,ffi*øæ,tolÌspecttlrcwsk I
ftnttler adhr¡æ¡fe*e tfiat ttre isnne dtfte gr¡tdhg krnit does rtr preïent the BrdeE Official from: {1}
reçrfuirgttreærrecti,on derrors lntftesrÉm¡tt*s, if amy"dsoouered afuriçsuancq or{2} stopp¡ng
gryrstn¡cfiü¡ gr ¡¡se d$re struchne{sf wfiacffitVf¡es} ff s¡d¡ b in rfttrion sf CoüiltV Re8lffist or arry dter
applicabhÍaw. Rer¡iewof thbAppfølirn, ildudrgsrÉrniuaÇ and ¡nspectíors of üework byü¡e BuiHirg
DiyÈS¡xr do notmrulit¡@il ãcæpt¡rreof rcsporÉffitysñabffitybf lheCowrtyderrurs,or¡ússioûsor
dbcrepancien- As the Orvner, I ac*næl@e that resposuibilÍty for cornpliance wittr federal, state and local laws
ard County Rqulrtúc¡s rest uiür nre and rny auttraiæ¡l agents, ¡rduútg willn¡t limitatien rny architect
orbuil&r..
I hËltl¡r ¡*¡orlcft ffi I tre rc¡d äd lr¡dcr¡¡rrl ûÊ tdirl nd Ccrtifialft¡n aùoul, ls r:fi ¡s, harc
proúüed TTre requíired information vr/hictr is correct and accurateto the best of my knowledge.
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Property Owner and Date
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Special Conditions:
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BU|IDTNG / PLANNING DIVISION :
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