HomeMy WebLinkAboutApplicationDocuSisn Envelope lD: CA6C3DC1-EF72-4086-9C83-D354C7CE3746
Comm unity Development Department
108 8th street, Suite 401
Glenwood Springs, CO 81601
(97Ole4s-82t2
www.garf¡eld-countv.com
Gurfield County
GRADING PERMIT
APPLICATION
TYPE OF GRADING
tl MAioR E MINOR
INVOLVED PARTIES
Property Owner:
Mailing Address:
Solvay
Phone:P70 I 285-0406
2717 Co Rd 215, Parachute, CO B'1635
Email Address:
celina.akin@solvay.com
Bid not awarded - Dale Day, Williams CM 509
(
71 0-8935
Contractor:Phone
Mailing Address
13781 Pacific Circle, Mead, CO 80504
Email Address
dale.day@williams.com
N/A
Architect;Phone:
Mailing Address:
Email Address:
DR Griffin 362-5028
Engineer:Phone:
Mailing Address:
1414 Elk Street, Suite 202, Rock Springs, WY 82901
, tmorrev@drg-WY
Email Address:
PROJECT NAME AND LOCATION
Project Nam
30" Drip Removal
Describe Work:At the Haybarn and Substation locations we are performing work to remove low point
liquids collection piping as it is deemed a risk of corrosion concerns without adequate means of measurement.
We are pro-actively removing these, they have been in service for only a few years and we do not have concerns
of corrosion/leaking having taken place to date.
Job Address:39.466845", -108.078729" Section 2, Township 7, Range 96
t82t cR, ztç,Porq.ehr¡{r, CO 8f a3S
Assessor's Parcel Number:240902200148
Sub.Lot Block
Earthwork (square feet) :
44523 Earthwork (Cubic Yards) :
1649
DocuSign Envelope lD: CA6C3DC1-8F72-4086-9C83-D354C7CE3746
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, or
anauthorlzedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterof authority,signedbythe
Owner, must be provided with this Application.
Leeal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the BuildÌng 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 Perm¡t.
Void Permit. A Building Permit becomes null and void if the work authorized ¡s 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 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.
by:
0"â** Al"à 6/30/202L
Property Owner Print and Sign Date
CERTIFICATIO]N
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. ln consideration of the issuance of the Build¡ng 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 appticable 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 or use of the structure(s)
and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law,
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. I
further acknowledge 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 (2) stopping construction
or use of the structure(s) or facility(ìes) 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 responsibillty or liability by the County of errors, om¡ssions 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, engíneer and/ or
builder.
OFFICIAL USE ON|LY
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Special Conditions:EFDÍ,o aF_¡åzÈoc
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PermitFee:
) oo e Misc Fees:Total Fees:
$Too. g'Fees Paid:*'loo .Ð
Grading Permit:
GRAD - ¡t6966,-
lssue Date:
:æ/eo/zstt ?LZoning:Balance dueí4rl
BUILDING / PLANNING DIVISION
DateSigned
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