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Home My WebLink AboutApplication>frl-uñ =ERgÉ (:," o Hñt J>\5 l¡J tsÞE= ıã 6ut l¡J(t t¡¡É Communlty Development Department 108 8rh Street, Suate 401 Glenwood Sprlngs, CO 81601 (e7ol e4s-8212 www.sa rf¡eld-countv.com E IulNoR l'- INVOTVED PARTIES _..,_..' I Propcrty owner: XTO Energy lnc.Phone:281 9394132 Mailing Address: 22777 Springwoods Pkwy Sprin , Texas 77389-1425 Emal Address. mark.f.warren@exxonmobil.com contractor: Williams Phone:03 775-0527 Malllng Address: 13781 Pacific Gircle Mead, CO 80504 EmailAddress:cra¡9. harris@williams. com Garfield County GRADING PERMIT APPLICATION Architect phone: Mailing Address: EmailAddress¡ : I Engineer: - - phone: Mailing Address: AND LOCATION Project PIC 30' Cottonwood Anoma Describe Work:Trenching down to our ex¡stíng pipeline and inspecting pipe to determine if that sect¡on of pipeline is functioni ng properly JobAddress: 11347 HWY 6 Parachute, CO B16gs 39.47 8027777 8 -1 07.99 1 0888889 Assessolr's Parcel Number:?r73 3t l0 oooz 5ub. Earthwork (square feetf : _ Earthwork (Cubic yardst:4500 ATT UTITITIES MUST BE TOCATED PR¡OR TO ANY GRADING lr.'lQngE Authorltv. This application for a Building perrit *usi be signeo by the owner of the property, dåscribed above, oran authorízed agent. lf the slgnature below is not that of the owner, a separate letter of authority, signed by the: Owner, must be provided with this Appfication. ' lcal Àcccss. A Bulldlng Permlt cannot be issued wlthout proof of legal and adequate access to the property for: purposes of inspections by the Bullding Dlvision. othar Permlt¡. Multiple separate permlts may be required: (tl state Electrical permlt, (2) county owTS permit, (3) anoth€r permit required for use on the property ldentified above, e.g. stðte or county Highway/ Road Access or: i¡ State Wastewater Discharge permit, Y!tC+gr+ A Building Permit becomes null and vold lf the work authori¡ed is not commenced within 180 days of ' the date of issuance and if work is suspended or abandoned for a period of lg0 days after commencement. CERNRCATION I hereby certifu that I have read this Application and that the information conteined ebove is true and correct, Iunderstand that the Building 0ivision accepts the Application, along with the plans and specifications and other' data submitted by me or on my behalf (submittals), based upon my certifìcataon as to âccuracy. Assumingcompleteness of the submittals and approval of this Applicatlon, a Buildíng permit wilf be issued grantingpermlssion to me, as owner, to construct the structure(s) and facilities deiailed on the submittalireviewed by theBullding Division. ln conslde¡ation of the issuance of the Building permit, I agree that I and my agents will complywith provisions of any federal, state or local law regulating the work and thãcamel¿ county guflding code, qWTS regulations and applicable land use regulatlons {county Regulatlonls}). I acknowledge that ihe Bullding permit may be suspended or revoked, upon notice from the County, ¡f the locet¡on, construction or use of the structure(sland facility{ies}, described above, arc not ln compl¡ance with county Regulation(s) or any other appllcable law.I hereby grant permissaon to th€ Buildlng Divislon to enter the prop"rty, d"r.ribed above, to ¡nsp€ct the work. Ifurther acknowfedge that the issuance of the Building Permit does not prevent the Building offlclal from: {l}requiring the cor¡ection of errors in the submittals, if any, discovered after ¡ssuance; or (2fstopplng constructionor use of the structure(s) or facility(iesf lf such is in v¡olat¡on of €ounty Regulation{s} or any other af plÍcable law.Review of this Application, including submittrls, and inspections of tnl *J.r uy the Building Division do notconstituts an ðcceptance of responsibillty or liability by the county of errorS orni¡rions or Jiscrepancies. As theowner, I acknowledge that responsibility for compliance with federal, stete and local laws and county Regulationsrest w¡th me and mY authori¡ed a8ents, including wlthout llmítat¡on my architect deslgner, engineer andl or' builder. I hereby acknowledge that I have read and understand the Notlce and certificatlon above as we[ as have provided the information which is Gorrêct and accurate to thc best of my knowledge. J 7¿/,/11 117 t2021 Property Owner Prlnt and Sign Date OFFICIA¡.ONtY Fnø*óar/úrye/âJed ût/t fr /,ng Condltlon¡:Specl¡l na knaun a 6Ø Øt 6 tupe 0ô Mlsc Ø æ ú çßAÞ -72î6 lssuÊ Oat€:Zonlng! BUttD¡tr¡G / ptANtrilt{G Dtvtstofrl : Sþnrd Approval DrtÊ zazlil-2q-