HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.,garfield-county.com
TYPE OF GRADING
❑ MAJOR
INVOLVED PARTIES
X-MINOR
Property Owner: ?6ity. -- ' '��1 N i)O t)M ] Phone: (� 4 _) ff7
Mailing Address: f ' lS rONAAVY�' ` 1,t'O� �} (iO V1601
Email Address: NAIdIM bb (DM el L]-Mai i • WA
Contractor: AM tl1' COM,OfkiYkeNkPhone:MCI ) 61 8 - V45
Mailing Address: b , S IVI -r I . rr 7 1 CO. Sudo(
Email Address: PA P,n1 e1ci I (VI? - C4 MA
Architect: , f c M f O Phone: (C1 j 3 k 44?2:.
Mailing Address: I is V"q au' Si- VA 1 &10c t to of F
Email Address: 'i�-M cy Iltcle " 1 TcC . td*M1
Engineer: AlitteA SSA C Vv1d« Phone: (_ 10 ) It 4 '" f � W
Mailing Address: 44$ ar Lim Qhl C w t w.
Email Address: Joimatm0 maimsm s'v CiiAntQ . arA]►"► k
PROJECT NAME AND LOCATION
Project Name:
Describe Work:
BOG* SW_r
Job Address: `�2'2— MUM 61 OMI U . tUU.or
Assessor's Parcel Number: ;O 1 d(e) 080
Sub. PlAi DV ,vim° Lot 150 Block
Earthwork (square feet): 3000 7 4- Earthwork (Cubic Yards):
ALL UTILITIES MUST RE LOCATED PRIOR TO ANY GRADING
NOTICE
Autherity. This application for a Building Permit must be signed by the Owner of the property. described above, or
an authorized agent. If the signature below is nut that of the Owner, n separate letter of authority, signed try the
Owner, must be provided with Has Application.
1._ggpjAmsp,k Building Permit cannot he issued without proof of legal and ;adequate access to the property far
purposes of inspections by the Building Division.
other Ptrrojt$. Multiple separate permits may be required; (I) 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
Vojl Pefmi3. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
the date of Issuance and If walk is suspended or ;abandoned for a period of IN days after commencement,
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hereby certify that I h-ve read this Application and tlu,i the information contained above Is true and correct. I
understand that the goading Urvision 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 Application, a Duilding Permit will be Issued granting
permission to me, as Owner, to construct the structure(s) and Iacilities detailed on the submittals reviewed by the
. Building Division. In consideration of the Issuance of the Building Permit, I agree that t and my agents will comply
• with previsions of any federal, state or local law regulating the work and the Garfield County Building Code, OWTS
regulations and appi cthir` land use rc--ul:ations (County itegulation(s)i. I acknowledge that the Building Permit
may be. suspended or revoke:1, upon notice tram the. County, if the location, construction or use of the structure(s)
.inci lacilrty(ii° , ) dI-.cribed above. an.! not in compliance with County Regulations) or any other applicable taw
1 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 Official from. (1)
requiring the correction of errors in the submittals, if any, discovered after issuaanre; or (2) stopping construction
or use of the structure(s) or fadllty(ies) if such is In violation of County Regulations) or any other applkabie law.
Review of ttais 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 responsibility for compliance with federal, state and local laws and County Regulations
rest with me .irul my authorized agents, including without limitation my ;++chitect designer, ent;incrsr and/ or
builder.
hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the required Information which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
OFFICIAL USE ONLY
Special CondiUonz!
fel/
Date
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j ,4,31I 4 Z--i
B-.), LA .
Permit FOP;
$100.00
Balance due:
$0.00
BUILDING /PLANNING ENVISION
Mist Fees..
Grading Permit:
GRAD-05_ 0-6297
PD. $100.00, CC, 5/28/2020
Total Fees:
$100.00
15541 11 05/28/2020
Fps' $100.00
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Date