HomeMy WebLinkAboutApplicationRECËIVED
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Pfoperty Ownêr:
Mai[ing Address:
Community Devêlopment Department
1089û street, su¡te 401
Glenwood Sprlngs, CO 81601
(970) 945-8212
www.earf ¡el d-counweoln,
Clough Sheep Company LLC Phoner 618-7749
PO Box 686
Emall Address:Rifle, Colorado 81650
ContÊctor:Bargath LLC Phone:803 \77s'0527
MallingAddress:13781 Pacific Circle Mead, Colorado 80504
Email Address:craíg.harris@williams. com
Engineer:David Bull Phone:irß ì 517-0301
Malllng Address:13781 Pacific Circle Mead, Colorado 80504
EmailAddress:david.bul
Þroject Cfou h Tie-ln Location
Describe Work:See attached scope of work. Disconnecting pipeline
Job Address:39.510014 -107.916817
Sec 16 6S 94W
Asgessor's Parcel Number:R019007
Êarthwork (sguare feet):12,960 Eârthwork (Cub¡c Yards):480
Garfisld County
TYPE OF GRADING
MINORMAJOR
¡¡ç¡¡¡E6; phone:
Melllng Addressi
Ëmail Address:
PROJECT NAME AND IOCATION
ALL UTILITIES MUST BE TOCATED PRTOR TO ANY GRADING
AUthoriw. lhls êpplicat¡on for â Building Permit must s¡gned by the Owner of the property, descdbed abôve, or
¿nâuthôrizedagent. lflhes¡gnaturebelowisnotthEtoftheowner,aseparateletterofauthoriry,signedbythe
Owner, musl be provided w¡th this Appliration.
Lssal Access. A Buildlng Permit cannot bê lssued whhout proof of legal ¿nd adequate access to the prope.ty for
purpoles of inspections by the Building Division.
Other Perm¡ts. MultìplÊ separâtê pêrm¡ts may bè rèquírêd: {1} Stâtt Electricål Permìt, (2) County OWTS Permit,
{3) ðnother permlt requlred for use on the Þroperty identlfied above, e.g. Sf¿te or County Highwãy,/ Roäd Access or
a State wastewâter Dischârge Permit.
Voldpermlt, ABulldintPermitbecomesnull ôndvoidiftheworkautholizediSnotcommencedwithinlS0daysof
thr d¡tc of i¡¡u¡nce and if work i¡ ¡usoendêd or ahãnrinned for r period of 180 däys after commencement'
dâtâ submitted by me or on my behalf (submittals), based upon my certificâtiôn as to accuracy. Assuming
completenèss ofthe submi¡als and approval ofthîs Applîcation, a Buildlng Permit will be issued granting
permission to mè, as Owner, to consÎruct the structure(s) and facilities deta¡led on the submittðls reviewed by the
Building Division. tn consideratÌon ofthe issuance ofthe Bullding Permit, I agreethat I and my agents will compìy
wlth provlslóns of any federð|, stäte or locäl låw reguläting thê rvork and th! G¡rfield County Building Code, oWTS
.egutations and ðppllcêble lãñd use règulations (County Regulation{t}). I acknowledge that the 3u¡ldinE Permit
may be suspended or revoked, upon not¡ce from the County, ¡f the location, coñslruction or use of the structure(s)
¡nd fåcility(ìesi, dascribcd ¿bôve, rre not in compli¡nce with County Regulation(6) ór any ôlhar âpplicãblP lew
I hereby grânt permìssion to the Building Div¡sion to enter the propefty, descr¡bed above, to inspect the work' I
funher âcknowledge thatthe ¡ssuañce ofthe Building Pemìt does noì prevent the 8u¡lding Offìc¡a¡ from: (1)
requ¡ring the correction of errots jn the submittais, ¡f any, discovered attel ¡ssuance; or (2) stoppiñg construclion
or use olthe structure(s) or fãciljW(iès) if such is in violatiÒn of County Regulatlon(s) or ¡ny other applicable larv,
Rèv¡ew of this Applicåtion. ¡ncluding submitta¡t and ¡nspections of the work by the Buiiding Divisicn do not
coñst¡þteânacceptanceofrespons¡bilityôfliâbilitybythecountyoferrofs,omissiônsordiscrepancìes. Asthe
Owner, I acknowledga th¿t rcsponsibility for complìan6e wilh federal, EÞ:e and local laws anrl Counly Regul¿iions
rest w¡th me and my authorl¿ed àgents, inc:uding without limitetion my architect des¡gñer, engineer end,/ or
builder
I hereby acknowledge thât I have read and understând the Nôt¡cê ând ãbove as well ãç
I hereby certify that I have re¿d th¡s Applicat¡on ðnd that the informat¡on
understand thãÌ fhe BuildinB D¡v¡s¡on eccepß the Appl¡cation, along wlth
have providcd the rêqu¡red information
Owner Print
contained above is true and colrect, I
the plans and specifications and other
to the best of my knowledge.
aMzz
Date
speclal cond¡tlonsi
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M¡s Fe6;û
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Ealanæ due:
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88-z?BUIIDING / PLÀNNING DIVISION
DateSrgned Approva'