HomeMy WebLinkAboutApplicationGurfield County
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GARFIEL
@,H[TIUNITY
Springs, CO 8X60X
945-82L2
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TYPE OF GRADING
tr MINOREI MAJOR
INVOLVED PARTIES
Shelton Properties LLC Phone:p70 )625-4182Propefi Owner:
Mailing Address: 1419 Airport Road Rifle, Co 81650
Emait Addrerr. wsd i@rof . net
contractor: Self or TBD Phone :f )
Mailing Address:
EmailAddress:
Architect: phone:()
Mailing Address:
EmailAddress:
Engineer:Zancanel la & Associates pton", P7o )
945-5700
Mailing Address:P.O. Box 1908 Glenwood Springs, Co 81602
EmailAddress:taz @za-engineenng.com
PROJECT NAME AND LOCATION
Project Shelton -H 13
Descrïbe Work:Construct access off Hwy 13 to cross Government Creek for residential
property access
Job Address. tbd HwY 13
Assessol's Parcel Number 2129-152-00-056
Sub. Lot Block
Earthwork (square feet): '1 1.780 Earthwork (Cubic Yards):2146
Att UTITITIES MUST BE LOCATED PRIOR TO ANY GRADING
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 certificatlon as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Buildíng 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 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 CounÇ Building Code, OWTS
regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit
may be suspended or revoked, upon not¡ce from the County, ifthe location, construct¡on 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 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(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 w¡th 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-
I hereby that I have read and understand the Notice and Cert¡f¡cat¡on above as well as
have required information is correct and accurate to the best of my knowledge.
Owner and S¡gn Date
AuthoriW. This application for a Building Permit must be signed by the Owner of the property, described above, or
an authori¿ed 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 Perm¡t 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 perm¡ts may be requìred: (1) State Electrical Permit, (2) County OWTS Permi¡
(3) another perm¡t required for use on the property identified above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permit.
Vold Permit, A Building Permit becomes null and void if the work authorized ís not commenced within 180 days of
the date of issuance and if work is suspended or abandoned for a period of 1-80 days after commencement.
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Balance due:+ø Gradint Permit:
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Approval
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Date