HomeMy WebLinkAboutApplicationRECEIVED
GARFIELD COUNTY
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Ìhis apflkation for a EuildÌng Pennit nx¡st be signed bV tl¡e Or¡mer of the p:operty, described ahoraeo
or an ar¡tlhorized agent- üf the s$gmturre bc{ow is not tdrat of tlfre Orrner, a separðte letter of authority, s¡gned by
üre Owner, murst be provided with this Applicatlon"
trrul A¡ces¡. A Buiilding FtnnnÍt car¡not be issued without proof of ll*gal and adequate acæss to üre propetty fot
purposes of inspectiÌons þthe Euildinlg Divisiìon"
Otls Pennit¡. lálr¡ltide sepan-ate pernfts nnay he rcquired: (X] State HeatrEcal Penm¡lt, {2} Cournty OWTS FerrnäÌ,
(31 another perrnit required fun use on tln poperty üdantmed above, e.g- State or bunty Highw¿V/ Road Access
or a State Wætewater Disdrarge Fermit"
VoH Penr*- A Burïding Ferrnit becornes nu¡lll ar¡d void if the work au¡thorized [s not comrnenced u¿itl¡in 1&) days
of the date of issr¡ance and Bf mrk b sr.uspeded or ahar¡doned fw a period of 180 dayr afrer con¡n¡encement"
CRTNGTNOT
I firerefu centÌfy that ll har¿e read ftis Appticatiion and'that the lnfonnation w¡tained above b trn¡e and correct- I
urdersf¿nd that the Burillding [livisior¡ accepts the Appllicatio:1, afiong wãth the plans and specificdtiøns and otlher
dat¿ su¡hr¡itted by rrnre or on my hehalll'(suhrnlrttals]" based upon íny cerüfttâtlon as to aöüræy- Assiirnlfig
connplleteness of tlne srubmitlaüs and approval of this Application, a Builldlng Fermit willl be issued g"anting
pernnision to rne, as o$ilner" to cor¡stnuat the stnucture(s) and facilities detailed o¡r üre suh¡nittals nevimred by
the BuûHÌrç Divùsion" In consideratäorn of the issr¡ance of üre Eurillding Perrnlq I agree that I ard my agents witl
cornpþ wlth provislons of any tederal, state ø llocal law regulatirg rhe wor* and the Garfiefid Cor¡rlty tsu¡üdir€
C-ode" OWTS reguhrtions and appllicable brd ¡¡se regulations {County Regulation{sl}- I adrnowlledge that the
Building Perrnit nnay be nlspended or reuoked" utpon no'ü-ce frorn the County, if the location" construst¡on or use
of the slnuctr¡rc(s) ard fæiiiqdks)" described above, are rþt in cornpliance with County Reguhtion(s] or ar¡y
other apflicab[e hw-
! trerehy grarnt perrmbsiron to the BuildÈng Dlvfsion to enter tl¡e property, describ€d abr¡e, to inspect the rcrk- I
further ackrnowlledge tlìıt the issuance of the Bullding Fen¡mit does not prevent the Bui8d[ng Offioã[ ítorn: (tr]
requuiring the correction of erro¡s in the s¡brnittals, if any, discovered after issuance; or {2} stoppftg
€onsûi¡ct¡on or urse of tl¡e stn¡ctr¡rre(s) ry tacihty{ies} if sudll is än r¡íolation of County Rqulation(s} or any after
applÌcable [aw- Reviw of ü¡r-s Appläaatäon, induding subnnlttals" aÍ¡d inspectbns of tfte wrk by tfte Buildiiry
Ðivr-sion do not constitr¡te an acceptance of nespor¡sibiliÈy or liabinity by üre County of errors, orrrissft¡r¡s or
discrepancies" As the Oums, å acknowledge tlrat responsibi[ity for cornpiance with feden-al, sffie a¡¡d nocaü fa¡n¡s
and County Regulations rest wiÛl rne and my authrorized agents, lnciudlng withrout lirnitation my architect
designer, gnglneer and/ or hdlden-
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6ea ¿t?aúeJ QIVD /T2A/SSpecid CotditÍms:
ådilrtedVakilion:l"qn4 æ w llanu. llqne Fec:
* 600,ô"ffiffio{zass.
Totelf€€s:tîÈ 2-nø-
BalanceFees Paid:
+600. oo
8P llo;
BwtF -17 7 î OWTSllo:
s€PT. 17 7 L
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