HomeMy WebLinkAboutApplicationGarfrcld CountY
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Ár-it¡ i .¡ .r,"-ÇommunityDevelopment Department
, ;, ¡'. ; .¡ ¡'ij,lj 10g grb streelSuite 401
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T] MAJOR
Ii¡VOLVED PARTIES
Property Owner:
Malling Address:
i rnrailAddress:
MINOR
Phone¡M:Ê/_LÍ4#__
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7Mailing Address:
fmail Address:
Architect:Phone:
Mailing Address:
[mail Addre¡s:
Êngineerr Phone:
Mailing
tmailAddress:
PRO'ECT NAMS AND LOCATIOÍTI
Proiect
De¡cribe Wo ü U
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ì
4
Job
4
Parcel
5ub.Iot _8lock
ôEarthwork {square feet}:€aÊhwork {€ublc Yards}:3o
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NoI!çs *
Authoritv. îhis apptication for á gu¡t¿inC i*i*itãuit be signed by lhe Owner of ihe properry, described âbove, or
.n *tt *¡.*¿ âgent. lf the $¡gnature below i¡ not that of the owner, ô lepðrðte letter ol àuihtr¡tY, signed by lhe
Owner, must be provided with th¡5 Appl¡cat¡on.
Lexal Acce¡s.. A Building perrnit cðnnot be issued w¡thout proof of legal and adcqu;te äceess to the property lor
purpories ol inspections by the Building Þivision.
Other permits. Multiple sepãråie permils may be required: (1) Stðte Electrical Perrnil, i2) County OWTS Permit'
(3) ¡nother permit required for ure on the prope.ty identified above, e.g. Ståt€ or County HiÊhwayl Ro¿d Accerr or
å Statc wästewâter D¡schðrge Permit'
\&idlg¡¡All A Building pefrïit becomes null ancl void if the wo¡k authori¿ed is not commenced within 180 daYr of
thÊ däte of issuance and if work is suspended or abandoned lor a period of 18Õ days after çommencement'
CERTIFICATION
I hercuy i*rrity *ãii ¡,rue rurd th¡s Applìc¡tion ;rnd that the informatioÊ contained.rbove is true and correct. I
understand thðt the Building Þivision açcepts the Applicatìon, along with the plans and specificalion: and ather
datå eüþm¡Ìted by me or on my beh¡lf {ssbmittalr}, based upon ÍtY certific.rtion a5 to accurãcy. Assumin¡¡
conrpleteness ol the çubmittals and approv.'rl of this Application. a Building Pernril will be issued Srant¡nt
permission lo me, ;¡s Owner, îo construct the structure(51 and låc¡lit¡es detailed an lhe 5ubm¡tt¡ls reviewed by the
Builcling Divisiçn. ln conriderat¡on of the is5uånce of the Bu¡lding Perrnit, I ðgree that I and my tlgents w¡ll comply
with provision: cl arry feder¡|, state or loeal law regulatinp. tlìe work ¡nd the Garfield Courty Euilding Code, OWTS
regulations and applicable land use regülat¡ons {County Regul"rtion{s}}. t acknowledgn thãt the Suilding Permit
rnay be suspended or revoke<j, .Jpon notice fro.n lhe County, it the locstion, ccnstruction or use ofthe structure{s}
¡nd facility{ies}. clese ribed above, are not in compliance w¡th coùnty Regulation{s} o, ðny olher applicable law'
I hereby grêni permisliûrì to the Building Divirion ts enter the proper{y, described ãbove, tç ¡nsPecl the work' I
fu¡ìher acknowledge that the issuance of the Building Perm¡t dogr not preverìt the Building Ôllicial fror¡r: {1}
re¿luiling the carrectión of errors in the subnittals, if any, discovereel after irsu¿nce; or {2} stoppinB constr{¡cÌion
or use of the çtructure{s} or facility{iet) if st¡ch is in violation of Çounty neP,t¡lation{:i or any otirer applicable law'
Review of this Application, including 5r,bmittal5, and inspcctioûs ol the work by the Building Division do Rol
co.lstituîe ¡n acceptance of rerponsibility or liability by the Countv of e¡ror-s, omiss¡on9 or discrepanciee. As the
Or,/ner, I .rcknowledg,e that responsibilil.y for csmpliðnce with fede¡al, st¡¡te ðnd loc¡l laws nnd CÔünty Regulations
r€st w¡th me ðnd nry authorized ¿Êents, including without li$itat¡gn my architect designer, engineer afió/ çr
,builder.
I hereby acknowledge that I ¡iuði""U and understand the Notice and Certification above as wella3
p rovided the required n whlch is correct and accurate to the be rny knowledge.
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