HomeMy WebLinkAboutApplicationfotzÞ ==() L¡ o tl¡ t.¡. ú, o ffä t¡J ñrolU tYl.É,ä t-2 munity Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 l970ls4s-8212 www.garfi eld-countv.com Gørfield County3 GRADING PERMIT APPLICATION TYPE OF GRADING tr MAJOR tr MINOR INVOLVED PARTIES Property Owner: Mailing Address: Phone: €ào I Ço/a3ÐZ EmailAddress:tO Contractor:Phone: I Mailing Address EmailAddress: Architect:Phone: (97Ô I æ/ ?22P Maíiing Address EmailAddress:'rt¿/ Engineer:Phone: Mailing Address: EmailAddress: o o PROJECT NAME AND IOCATION Project Name Q Describe Work: Job Address: Assessol's Parcel Number:23q3 otzë fo$q qqSub.Lot _Block Earthwork (square feet) :7oo e \ Earthwork (Cubic Yards) :Lro ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING NOT¡CE Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, or anauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedbythe Owner, must be provided with this Application. Lesal 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 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 Permit. Voidpermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0daysof 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 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 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, if the location, 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 ¡nspect 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 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 Cert¡fication above as well as have provided the requ¡red information which is correct and accurate to the best of my knowledge. .--Z¿zf rty Owner Print and Sign d/ftz lzozZ Date oFFtctAL usE oNLy PArÞ * too.ôÐ cK.tt 5l5E o1/ tL/zazzé9,'> Special Cond¡t¡ons: ^ l, , - , r t6mdúaTafautneY$ rlèk zn/n2 t' éur/drny cay'e, tE¡7¡Ar{/ Permit Fee: * loô.oo Misc Fees:Total Fees:* 106.ø Fees Paid:{ loo.ôo Balance due:*y'Grading Permit: (rRAÞ -1.++7 lssue Date:q-Ì>7- - Zoning: F u.s. {Uil,q-/7-2 Date BUILDING / PLANNING DIVISION Signed Approval