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HomeMy WebLinkAboutApplicationGøffield County Cornmunity Development Þepartment 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (9701945-8212 www.ga rfield-cou ntv.com TYPE OF GRADING tr MINORtr MAJOR INVOTVED PARTIES EmailAddress: Phone:Property Owner:L1L , LLL A?IMailing Address rlÁ ll ¿.{ù \ Email Address: aContractor:Phone: Mailing Address:Po BoY lo I ït? <: l{ C-ô Mailing Address: EmailAddress: Phone:Architect: trr\i^:$,r.f onon",L¿-h 'Bc"nd a.lr<Sr*¿Engineer: Mailing Address EmailAddress: PROJECT NAME AND TOCATION ì ¡¿ r-.lrrDescibe Work: (ì¡{Job Address: Earthwork (Cubic Yards): r Lc.n e- \ v et.5 0 e,åt BlockLot Project Sc å¿r c Earthwork (square feet): Sub. CR 1Èct, Assessoy's Parcel Number f t'e.t fLb ¿.l5or't 'wetrsi# Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. lf 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. Mult¡ple separate permits may be required: (1) State Electr¡cal Permit, (2) County OWTS Permit, (3) another permit required for use on the properry 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 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. 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 th¡s Application, a Building Permit will be issued granting permission to me, as Owner, to construct the structure(s) and facilities deta¡led on the submittals reviewed by the Building Division. ln 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 GarfÏeld County Building Code, OWTS 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, ifthe location, construction or use ofthe structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law. I hereby grant perm¡ssion to the Building Division to enter the property, described above, to inspect the work. I further acknowledge that the issuance of the Build¡ng Permit does not prevent the Building Official from: (1) requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use of the structure(s) 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 not const¡tute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner, I acknowledge 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. CERTIFICAT¡ON ALL UTILIT¡ES MUST BE TOCATED PRIOR TO ANY GRADING NOTICE I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provided the required information which is correct and accurate to the best of my knowledge. s/*,/at Property Owner Print a Sign to^r{ oFFrcrAr usE oNrY fl ,€ c¡.tl tFT o.f 20zl Soecial Conditionsr ír'çLrqr Lç¡rfi oc iln øns. co+riz*c¡qT 14â^ ì377 F.*r PaîsstY4L p,r;tq #,' Ðd-rr,s, SrcoE llwob6 Fa Misc Fees:Totel Fees: I qoo.cc Fees Pa'lÍ: Ir+oo.gPermit Fee: { {oo.oj Zoning: 2.u¿ÀL Grading Perm¡t: GßAD -,686$ ¡1 lssue Date:Balance due+l ß'\S'7ozl Date BUtTDTNG / PLANNtNG D|V|STON