HomeMy WebLinkAboutApplicationGarfield County
Community [tevelopment Department
108 8th Street, Suite 401
Glenwoud Springs, CO 8160I
(sr70) 94s-8212
www.qerfie ld-cou ntv.com
TVPE OF GRADING
tr MAJOR
INVOTVED PARTIES
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Property Owner:
Mailing Address;
Contractor:Cr¡C C¿¡l 5tt¿ut-t''sc¡urJ s.t ¡¿Phone:
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Architect: {€:çuvn0\\ (r'.JS:ÕY}\ \\ów\áS Phone:(?o3 ) q-15'- Llt{(3
Mailing Address: \J \nAçL ÉôÊ</l r g\b{-6 êò ¡ 1¡¡ç.L , (g, gW61
EmailAddress: frwf¿ çG {Visr¡Ít9l+ OgU, Co,n1
Engineer: €æqÆf*-¿úL fY\Ê\.r.¡^f\ç\t-J C{455 ÉNGrir@nã!'Phone:(41ı ) RttS-66Wt4
Mailing Address: $J.ta tla éß-â.^¡0 p\rg ¡ GtitNwr¡yl átf+r,r.{rÍ , (A. B\frÁl\
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PROJECT NAME A,ND TOCATION
Project Name Fç'nuc.f Coirscffq lrf tr€ Mxtt tW û\tt€þ,Ì S /t¿tì,r€tvfv\iok.
DescribeWork: 4xcnv¡rcço.ù ÈßJ0 bl-X(lr-i+Jfy Ë.r¿- ¡./grrJ L'rltßt-¿øer¡s<fn-
ô(6¿.,*s.¡¿.¡¡s ßustør;.^/G. Lç¿¡..¡*çso¡) f¿V- :i\,\tëêr{' 6\{.J<suV-l ur..¡l\(.f-.
Job Address:Þ-\ooo .lrr^,,o É¡uer¿-S QL,IZA Q-$ t Gt-epwootl lt¿:[\¡Jø,S , Ø,
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Assessol's Parcel Number , + 3\95- ô\\D - cÒo5
Sub.Lot Block
Earthwork (square feet):ãooo óF Earthwork (Cubic Yards):O¡,7oO <-r1
ALL UTIL|T|ES MUST BE TOCATED PRIOR TO ANY GR¡IDING
NOTICE
Authorltv. This applir:ation for a Building Perrnit must be signed by th,r: Owner of the property, described above, or
an authorized agent. lf the signature below is not that of the Owner, ¡it separate letter of authonity, signed by the
Owner, must he provìided with this Applicatiolt.
Legal Access, A Builcling Permit cannot he issued without proof of legi;l and adequate acces$ t,rr the property for
purposes of inspections by the Building Division.
Other Permits, Multiple separate permits may be required: (1) State li:lectrical Permit, (2) Courrty OWTS Permit,
(3) another permit ¡srquired for use on the property identified above, û,9, State or County Highway/ Road Access or
a State Wastewâter flischarge Permit.
Void Permit. A Building Permit becornes null and void if the work authorized is not comrnenced within 180 days of
the date of issuance ;irnd if work is suspended or abandoned for a perir:d of 180 days after commencement.
CERTIFICATION
I hereby certify thât I have read this Applicatinn and that the informatic¡n contained above ís true and correct. I
understand that the ltuilding Dívision accepts the Application, along with the plans and specifinations and other
data submitted by m* or on my behalf (subrnittals), based upon my certification as to accurac!'. Assuming
completeness of the submittals and approval sf this Application, a Building Permit will be issuerf granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Division. ln c,nnsideration of the issuance of the Building Pernr'it, I agree that I and my ngents will comply
with provisions of an1¿ federal, state or local law regulating the work and the Garfield County Building Code, OWTS
regulations and applirr:able land use regulatiorrs (County Regulation(s)),, I acknowledge that the Building Permít
may be suspended or revoked, upon notice fr,rrm the County, íf the location, construction or use of the structure(s!
and facility(ies), desclibed above, are not in cumpliance with County Regulation(s) or any otherr applicable law.
I hereby grant permi$sion to the Building Diviri;ion to enter the property, described above, to inspect the work. I
further acknowledge f:hat the issuance of the lSuilding Permit does not prevent the Building Ofl"icial from: (1)
requiring the correction of errors in the subrnìttals, if any, discovered ¡nfter issuance; or (2) sto¡:ping construction
or use of the structur,e(s) or facility(ies) if sucli is in violation of County Regulation(s) or any othier applicable law.
Review of this Application, including submittals, and inspections of the work by the Building Division do not
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the
Owner, I acknowledg{} that responsibility for compliance with federal, state and local laws and County Regulations
rest with me and my iruthorized agents, incluiling without limitation my architect designer, en{{ineer and/ or
builder.
I hereby acknowlerrlge that I have read ¡¡nd understand the Notice and Cert¡f¡catiom above as well as
have provided the requ¡red information which is correct ärîd a,ücurate to the best of my knowledge.
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Owner Priint and Sign Date
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OFFICIAL USE On¡LY ?d. {ltos.oo c.C. tt totfzø¿L-säÞ
speciarconditionsr outnerVrazæ/s ataah rÊk stq¿ê
+v rew'øct af z%e ,e/âr¿ey' Jur)UVpøÉ
Permit Fee:f loo. @ Misc Feesl Total Feeri¡¡
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Fees Paid:.#,ôo.oo
Balance due:fø Grading Pennit:
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Issw-Qfllln:
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Zonlng:
PUPA L-
BUITDING / PTANNIN$ T'IVISION ://,3,2021C%4ä-
Signed ltlpproval DãIe