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AGRICULTU RAL EMPLOYEE AFFIDAVIT
FOR EMPLOYEE HOUSING
state that the residential structure
described below will be occupied solelY as an agricultural employee dwelling unit
without rent provided to an individual and related family member who is/are employed m
agricultural use, including farms, garden,greenhouse, nursery, orchard, ranch, smallan
Garfield County Land Use and Development Code'
It is agreed that proof of employment, in the form of Internal Revenue Service Forms
W-2 or 1099 for each person employed as described above will be submitted to the
Garfield County Community Development Department upon request by the county'
Failure to províde this information for each year the unit is occupied will result in a code
violation, ievocation of this status, and fines allowed by law.
It is agreed that this property will not be sold to another party without representing that
the aficultural empioyée dwelling structure is for agricultural employees only and may
not be used for anY other Pulpose.
Properfy and Building Description:
animal farm for Production of poultry, fish, furbearing or other small animals, as
prescribed in the Garfreld CountY Land Use and Ðevelopment Code. I further state that
the residential structure is located on Agricultural Land defined in Article l5 of the
Address 1Z
Assessors Parcel Number
Building DescriPtion
Owner (Signature)
Owner Address
Date
Witness
This form will be recorded with the Garfield County Clerk and Recorders office as
reference for any future title searches'