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Garfield 'o ff 1 Building permit application
Application
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Application Date 02/16/2021
Parcel Number 2391 1300026
Permit Type* Demolition
Project Address* 2621 County Road 100
city* Carbondale
Block
Lot
Section -Township -Range Enter in the following format: gra` tt11-##
Subdivision Ries Subdivision Exemption
Zoning R- Rural
Applicant I Owner* Lawrence and Lisa Singer
Mailing Address same as project Yes No
address? *
Owner Phone* (720)220-8400
Email Address* Lssinger co cast -net
Email Permits * I would like the permit documents emailed to roe.
t Yes
No
Representative (Arch, Eng, etc.) Lawrence Singer - Owner
General Description*
Please be as Oekailed as pvssible.
On January 2, 2021 our Garage and Greenhouse building
had a fire and was destroyed. Akso inside the garage was
an RV that burned completely.
We would like to have approval to demolish the building
and remove the debris.
Permit fees:
Demolition Permit Fee $ 25.00
Acknowledge and Signature
Notice andcertification:
arrow to fight to expand Notice and Certification,
NOTICE
Authq tty. 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 not that of the Owner, a separate letter of authority,
signed by the Owner, must be provided with this Application-
LegAccess- A Building Permit cannot be issued without proof of legal and adequate access to the property
for purposes of inspections by the Building Division.
Pther Pprrnits. 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.
.Permit. A Building Permit becomes null and void if the work authorized is not 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 tiie 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. OWTS regulations and applicable lend 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 or use
of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any
other applicable law,
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 Officiar from (1)
requiring the correction of errors in the submittals, if any. discovered after issuance: or (2) stopping construction
or use of the structures) or facility(ies) 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 riot
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As
the Owner, 1 acknowredge that responsibility for compliance with federal, state and local laws and County
Regulations rest with me and my authorized agents, including without limitation my architect designer, engineer
and/ or builder
Acknowlegement: *
Signature:
*
I hereby acknowledge that I have read, understand and
will abide by the requirements of the Notice and
Certification listed above: as welt as, have provided the
required information which is correct and accurate to the
best of my knowledge
„elit r��t
Payment Portal
Submission Complete?*
Online payment portal:
I hereby acknowledge that I understand payment is
collected at the time of this form submission. The section
below includes a link to the Payment Portal. [ will not be
able to complete my submission without entering the
Transaction Number from the payment portal. I agree not
to submit the payment until [ am ready to submit this form.
I am not ready to submit this form. (Please choose Save
as Craft)
Please click on the link below to enter an online payment_ Once you receive the transaction number from
the portal, please enter it in the field below to proceed with your applic-ation.
Cli0,_here to open On['pe PayrnkoLportal
Transaction Number:*
OSFMV49MMA2
Please inter the transactiun number from the online payment.
Confirm Transaction Number:* OSFMV49M1v1A2
P:case re-enter the transaction nurnbur from the online payment_
Community Development - Transaction Receipt
Response Success
Amount $25.60
Pay To Community Development
Billing Address 2621 County Road 100. Carbondale, CO 81623
Account Type MasterCard
Card Number (7 - X- X -3724
Name Lawrence Singer
Billing Address 2621 County Road 1OOarbondale, CO81623
Email Address Lssinger a. orncast.net
Reference Number QSFMV49MIVIA2
Authorization Agreement
I, Lawrence Singer. authorize Dornmunity Development to electronically charge my credit card
the amount indicated above,
My entry of the information above and the checking of my acceptance of this agreement .shall be
to execute this transaction_
account for
my signature