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Home My WebLink AboutApplicationGørfield County GRADING PERMIT APPLICATIONCommunity Development Department :!, it. :, ., ;. : 108 8th Street' Suite 401 Glenwood Springs, CO 81601 FJì,il,i.iñi il;*.iä¡'i J',i' ts7 2! s.1s821: @ TYPE OT GRADING tr MAJOR tr MINOR INVOLVED P¿BTIES Property Owner: Mailing Address: Caerus Piceance LLC 143 Diamond Ave, Parachute, CO 81635 pr,one: P70 ) 285-2656 EmailAddress:jeckman@caerusoilandgas.com contractor: RBW Inc'Phone: P7O 1640-6942 Mailing ndAåss 570 S Westgate Dr, Grand Junction, CO 81505 EmailAddress:JeremyG@rbwinc.org Architect: Phone: (-)- Mailing Address: EmailAddress: Engineer:Uintah Engineering and Land Surveying phone:f435 ) 789-1017 Mailing Address:85 South, 200 East Vernal, UT 84078 EmailAddress:bbowthorpe@u i ntahg rou p. com PROJECT NAME AND LOCATION Project Name:NPM M33 496 p ipeline Describe Work:Grading of pipeline ROW to install a buried 1O-inch, steel, 3-Phase Liquid pipeline The total length of grading is7,029 feet long and the width is 40 feet wide. Total area to be graded and reclaimed is 6.45 acres. 5,302 in existing pipeline ROW and 1,727 parallel an existing road. Job Address:NPM M33 496 well pad. SW 1/4, SW 1/4, Section 33, T4S, R96W, 6th PM Assesso/s Parcel Number:191 529400002, 1917 27 400012 Sub. Lot - -Block Earthwork (square feet):281,160 Earthwork (Cubic Yards): 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. Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of 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 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, if the location, construction or use of the 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 inspect 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 Certification above as well as have provided the required information which is correct and accurate to the best of my knowledge. B/ZØ/zÒzB Owner Print and Date ırncnl usE oNrY l special conditions: Câ-W-öc- Þ bI1-- pu¿rç{"- ¿}fl}-{) r¡sG- æ6€¿Ð cctr¡.¡ì-I U€GfaA'I-tqÊ ^ê.trè{rø+ctË( @ ArPRV-oâ^ã 6- v6=€Í->.*tn-Y- "E\fii oc)Fees Paid:qry) ooe"''i¿¡¡roe Misc Fees !.s-æ: KU Zoning:Balance due: æ Grading Perm¡t: (^ç..1s -8â"K tô - (6 -23BUILDING / PLANNING DIVISION : DateSigned