HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
, 108 8th Street, Suite 401
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GRADING PERMIT
APPLICATION
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INVOTVED PARTIES
EmailAddress:
Property Owner:
Mailing Address:
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Phone:
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EmailAddress:
Contractor:
EmailAddress:
borryþ phone:
Mailing Address
Architect:
Phone:2Engineer:
Mailing Address:
EmailAddress:
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Earthwork (square feet) :
PROJECT NAME AND TOCATION-t
Project Name
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Job Address: ¿
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Assesso/s Parcel Number
Describe Work:
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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.
Leeal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Divisiorr.
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
lherebycertifythat lhave read thisApplication and thatthe information contained above istrue 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 aceuracy. 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)). All County development requiring a permit, except for residential uses, are subject to Article 7 of
the Land Use and Development Code. 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 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 Bullding 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 bythe 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
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
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TOFFIC¡A!. USE ONIY
Special Conditions: -.
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Zoning:
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Date