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HomeMy WebLinkAboutApplicationGarfield County Community Development Department 1OB 8th Street, Sulte 401 Glenwood Springs, CO 81601 l970le4s-82L2 www.ga rfield-cou ntv.com WPE OF GRADING tr MAJOR ET MINOR INVOLVED PARTIES Property Owner: Mailing Address: L.¡g¿À) ÊJ\ts"phone: ( 4'ao I 6tq- 6G6o P.Ò. tsÔ* .p 3gú\. t¡tt^ Co. I 6) EmailAddress: 9. Ê ¡fe*¡cr-rvþl" @. \lrxvturtcu. Csln^ Contractor:Fusa- î-'¡r*Phone: (4,1o I arEQ - SqoI Mailing Address: EmailAddress: ,o, ÊeT g"\ÉELç CÓ-€> Fuse¿. {stz(æ â,í¿J.)(:Ë. (rsizrrr Architect: Phone: Mailing Address: EmailAddress: Engineer:LT NÚTu8(. û¡ru¿Ù s{\J(-.Phone : l4-1,¡.) ¡ Ð:t\ - octt)lê Mailing Address: Email Address: €oO &rrþU À\rG, &&A^r0 æùJ .¡r,r¡J , Lô. Bt60t PROJECT NAME AND LOCATION Proiect Ar..rI veu ce Describe Work: SroruÉ' Çg-¡osuU éx,cx.raana¡*J å o S &,¡- ÉF,^J(rtE fayvu Job Address:LòT J. gr.tgE^J rrr¡;*r¡ß- t¡SÛr\r&s:oJ, ¿g Arl[r, 6rrr, Co, rBD Assessol's Parcel Number:2l1g ' 16l ,o? .óó3 Sub.P.r€ilÉN M r ño t':L Lot P _Block Earthwork (square feet):5, OoO 5ç Earthwork (Cubic Yards) :?so (-Y ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING ' NOTICE Author¡tv. 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 Perm¡ts. 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. 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. 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 Dívision 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 wíll 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 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 locat¡on, 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 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 Officialfrom: (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 inspectíons of the work by the Building Division do not constitute 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. I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provided the requ¡red information which is correct and accurate to the best of my knowledge. qle\l a t Property Owner Print and Sign Date ztOFFICIAT USE ONIY AlOO. cP Cc 77Cr/ OúÄ fæ-twf Pz¿,¡< Qtøt^?L Æ Q,o^rça5lòO. /ru-r1/ttT A l¿.tl F-t'.) fitst, ?u,*/Æq 5î3Te Condltions: ùox Special lÐtur ñat1 o ¡ç' Ou /J. Total Fees: $ /oo,oo Fees Paid: $ locl.ôo Permit Fee: f locr . oo M¡sc Fees: lssue Dete: 9Tp+Jzt Zoning: fzvB.{L Balance due:16 Grading Permlt: ca?^D -1111 27-)ÞzBUTTD|NG / PTANN|NG DtVtStON / DateSigned