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HomeMy WebLinkAboutApplicationTie Garfield County Community Development Department 108 8th Street, Suite 401 Glenwood 5prinp, CO 81601 (970)945-8212 www.earfield-countv.com GRADING PERMIT APPLICATION TYPE OF GRADING ❑ MAJOR Or -MINOR INVOLVED�//PARTIES n4: Andrea � Ow Phone: 16 15 ) 9 s -70 ?777 Prapi- r�ty l�wL Mailing Address: IS 4A cheek Ra Nciv Ie n ) 7Zc5' Email Address: am iuptow© rail .com Contractor: eo r-f- tVek rnert Phone: (9io) 30' - 9740 MailingAddress: 19 EI f in Pace 61enwo d *-rr,0\4) Co Email Address: 601CI 5 i8, 4©I ,com Architect: VAvt "''' W� f I Phone: (l70„)l9-+ { 100 _ sr Mailing Address: Jg amond A t C ..k . GI (7oi ldd1G Email Address: daUid (42) strr ker k3rOwn , Goir Ersinaer: k.ic-J-#"tn VotCla I Phone: P2C3 t 628- 5o 15 Mailing Address: 11232 1 f YV Q 4t l'iN Cenierva CO eo I l2 t Email Address: CIO ieZQ I S C `I" . GOrr\ PROJECT NAME AND LOCATION Project Name: 1-.OW IZt m1 at e Acid 1 than Describe Work: i (47 Additiir Job Address: 512 I- C la loo Ri miedge) Assessors Parcel Number: 17-00 S4 7 I sub. Weeir F-Jml e. Lot " Nock Earthwork (square feet): 2000 Earthwork (Cubic Yards): 360 ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING NOTICE Authority. This application fora Buk{dEng Permit must be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Application. Legal Access. A Building Permit cannot be issued without 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 Permit becomes null and void if the work authorized is nut commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICATION I hereby certify that I have read this Application and that the information contained above is true and correct. I understand that the Building Division 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 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, in 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, Ow7S 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 Of use of the structures) and facflity(les), described above, are not in compliance with County Regulations) or any other applicable law. hereby grant permission to the Building Division to enter the property, described above, to Inspect the work. further acknowtedge 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 issuance; or 12) stopping construction or use of the structure's) or facility{les) 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, 1 acknowledge that responsibility for compliance with federal, stare and local laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer, engineer and/ or builder. T hereby acknow(edee that 1 have read and understand the Notice and Certification above as well as havei•ovided the required information which is correct and accurate to the best of my knowledge. FOP- REA. L L(171- W Property Owner Print and Sign Date OFFICIAL USE ONLY specialrUndifiotti:;1 -- PA—V-07 .. 7 iSit' Y-th/t- . )AlCr 71( ,02-7(-44-4.-/7- y Permit Fee:' 100 11Aisc Fee= Total Fees* I DO Fees Pail.' o ' Balance due: _ _ IAI Grading Permit: &p PD_r b Issue Date: Zoning: IRtK 10/20/2020 BUILDING / PUmps NG DIVISION /0 �2o . 21 - Sig Appr of Date Fwd: permit application Page 1 of 2 Fwd: permit application Andrea Luplow [amluplow©gmail.com] Sent: Thursday, October 15, 2020 1:32 PM To: Rolland Luplow, MD tThis sender is trusted. Forwarded message From: David Brown <david[a strykerbrownrcom> Date: Thu, Oct 15, 2020 at 1:20 PM Subject: permit application To: Andrea Luplow <amluplow@gmail.corn> ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING �y . Thu aPght:al on Inr a Nua4 r.p dal mil toss! 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