HomeMy WebLinkAboutApplicationGarfield County
GRADING PERMIT
APPLICATIONCommunÍty Dorelopment Department
t08 8'h Street, Suite ¡l{11
Glenwood Springs, CO 81601
l970l94s-82L2
www. sa rf ¡eld-cou nw. com
TYPE OF GRADING
R uruon
t"3
MINOR
INVOTVED PARNES
Pfoperty Owner:
Mailing Address:
Email Address:
Phone:
t
ConÛactor:Phone: l-?335-Jrfiq9--
Mailing Address:
Email Address:
ê
Architect:Phone:qo
Mailing Address:?
Email Address:a
Engineer:Eg Phone: Iq+A I qb3^32 " t
Mailing Address:
Email Address:
!
PROJECT NAME AND LOCATION
Proiect luame: ['{Ír^t r\OuS€
Describe Work:c,Ûv o lt0tJ
Job Address:\
Assessol's Parcel Number:
Sub.€'su CpØrñbs Lot l2l _Block
Earthwork (square feet):
\),
Earthwork (Cubic Yards):
Owner, must be provided with this Application'
LeFal Access, A Building perrnit cannot be issued without proof of legal and adequate access to the propefi for
purposes of inspections by the Building Division'
bther permits. Multipte separate pérmits may be required: (1) State Electr¡cal Permit, (2) County OWTS Permit,
(Ð "*tt "|.
permit required for use on the property identified above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permit.
void pçrmit. A Building permit becomes null and void if the work authorized is not commenced within 18o days of
the date of issuance and if work is suspended or abandoned for a period of 18o days after commencement.
signed by the Owner of the property, described above, or
the Owner, a separate letter of authority, signed by theAuthoritv. This aPPlication
an authorized agent. lfthe
for a Building Permit must be
signature below is not that of
cËRTttrcAnoN
builder.
nty,
êr,
designer,
correct.true and!sabovecontainedthatandinformationthethishavereadthatApplicationcertifyhereby otherandandthewiththespecificationsplansalongDivisionacceptsApplication,thendundersta Buildingthat
Assutoascertificationaccuracy mingbasedonbehalfuponmyor(subm inals),mesubmitteddata myby
issuedwillPermitbe grantingthisofBuildingbmittalssuApplication,andthe approvalofcompleteness thesubmittalsreviewedondetailedbythefacilitiesandtheOwnerasstructure{s}constructtotolÏlê,permission willand complythatof¡dBui agentsmytheoftssuancethePermit,tng âgreeconsidelnrationBuildinDivisione OWTSCouCode,BuandworkGarfield ildingthelawthentyorstatelocaofregulatingfederal,with anyprovrsrons
the PermitthatacknowledgeBuildinglation(s ).useland (County Reguregulationsandapplicableregulations
useor theofconstruction structure(sCouthetheiflocation,fromnoticeorurevoked,ponbesuspendedmay lawaorotherapplicablewithncenynotareRegulation(s)Countylncompliadescribedandabove,facility{ies),
work.thetothedescribedinspectabove,entertotheto¡tdiBu propertyDivisionntlsslonngherebygraperm
from:OfficialthedoesPermit&tilding {1}not preventtheissuancetheBuildingofthatrthertuacknowledge
constructionafterorifdiscoveredissuance;stopping2ltheerrorsofsubmittals,any,lncorrectiontherequiring lawotheraorviolationlnofapplicablenysuchiflsCountyRegulation(s)oruseortheof facility(ies)structure(s)notdotheDivisiontheofworkndbyBuildinginclinspectionsisthsubmittals,of udingReviewApplication,
As theoromlsslonsthediscrepancies.ofor errors,liability by Countyofanresponsibilityacceptanceconstitute
Couandandstatelocalaws Regulationswithntycoforfederal,m pliancethatOwnresponsibilityacknowledge orand/without itation eng¡neerlimmyarchitectincludingauthorizedwithrestameagents,nd my
AtL UTILITIES MUST BE LOCATED PRIOR TO ANY GRAD¡NG
iloncE
l- herébry acknowledge that I have read and undertand the lbtice and Certiftcation above, as well as, have
provided the required infomration wh ich is correct and accurate to the beEt of my knowledge'
l;7
Property OvYner Print and Sign Date
OFFICIAL USE O'{LY
)sKt¿r4F/.,'S Dzr<g/t¿Cn ,*TSpecial Conditions:B4Ðt
n*t I73.Ð. Pr-*L¿/'*-Ì'u)
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Fees prrd:
I OO _rotal Fees:
lu)-Misc Fees:PermitFee: l9o-
Zoninc:-flrnlssue Date:Grading Permit:
Gß&-toTko*"úEalane
Ø 6-8-t onBUttDlt{G / PtANNlt{G DlVlsloN :
DntêSigned
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06/08/2020