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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
le7ol945-82L2
www.ga rfield-county.com
Garfield County
GRADING PERMIT
APPLICATION
TYPE OF GRADING
tr MAJOR tr MINoR
Property Owner:
Mailing Address:
EmailAddress:
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INVOTVED PARTIES
Contractor: Cßf\'^4Vr¿D D€5t 6 P Bq t Lr)
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Phone: 147O¡q 63'3s33
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EmailAddress:C,R*N FefL¡OÉl Gx:9u t rT) ,ø c¿ßJ-t N ÊT
Architect:
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Mailing Address:
EmailAddress:
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Engineer: L:R\J VT K eu¿ *K L*N6tt¿t#ttl6 phone:a 1lz7 "zz
Mailing Address
EmailAddress:
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PROJECT NAME AND LOCATION
Project N lÞv>"1¿F
Describe work: N È t'1/ l-føA g
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Job Address:b GÞt>ez'.t fizt¡F K gFM Cl_rcN cø,.91 bz->
Assessol's Parcel Number:z3q9 I q .l ô/ ı5ø
SUb. AçPjW GL€M Lot Block N¿
Earthwork (square feet)91Lëú Earthwork (Cubic Yards) :2-qû
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ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
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.
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 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.
VoídPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80daysof
the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement
CERTIFICAT¡ON
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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 land 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 location, construction or use ofthe structure(s)
and fac¡lity(¡es), described above, are not in compliance with County Regulation(s) or any other applicable law.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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
uilder
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the required on ts and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
OFFIC¡AL USE ONLY ?n,tO S loo. o.' er-.* I8-l87 og /zi lzozz ébÐ
Special Conditions: ,a- - þ rad)'zq a.h a'//m,9 nþk
burdry 7e/m? ret'/tØ FØ¿<I
Permlt Fee:
f loo. o'Misc Fees:Total Fees:ftoo,a"Fees Paid:$ lÒo,ao
Balance due:,+Ø Grading Permit:
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lssue Date:Zoning:
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BUILDING / PLANNING DIVISION :/o.3.32til,I+h
Signed Approval Date