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Home My WebLink AboutApplicationGurfield County R E €q'r4munity Development Department 108 8th Street, Suite 401'F'Fr' : fr gfp4wood springs, co 81601 r (970194s-82L2 wwiiviAS rfi el d-cou ntv.com'.._ i,t,., (rr i,,,, r,-,,,,.,rFrTlfF TYPE OF GRADING tr MAJOR B vtttttoR INVOLVED PARTIES Property Owner: Mailing Address: EmailAddress: tbbo r ra.a1q Rl(la C,- Phone: ( cl?o | "18Q- oLET g ttfrr .Qovc ,n,'Vla <rn nLa ,a tn4/l . fD/fr Contractor:lhr* n^) rl4r Phone: (er1c, ) l?h-ot;b7 ttsr>Mailing Address tLLLI cxe 25q ?i.0te fB EmailAddress:-0 rt ,t a .rrt)(h, (a, ,* c re,.n /.rt Architect:lL t". ar.tnQ f-Phone:( ?ao tqQ q O Aft- Mailing Address EmailAddress:nlrovp r./rln 4.-*Le ,/ rurqiA . Engineer: luoto M Gr,S'.n"..< Phone: (<'l,o | 1uG bqb Mailing Address: EmailAddress: Ir I P-c.v 3""( bl * ?:,e 9lc ?-- Cll l-,.--r PROJECT NAME AND TOCATION Project Na Describe Work:F., .^,.\i,rn .a.[- <: \r L.L.-^ / AOrr Job Address:I t^L n atQ 164 ,Q t"4lp (^tst Lsh Assessor's Parcel Number )I51 2Ltt oo JgV Sub. Lot _Block Earthwork (square feet):3cro c>Earthwork (Cubic Yards): 7t d^ A(trrl'. Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Application. lesal 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 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 Regrrlation(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 Buildirrg Division to enter the property, described above, to irrspect 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. ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING NOTICE I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provided the required information which correct and accurate to the best of my knowledge. l- eV - 4rnatl Property Owner Print and Sign Date OFFICIAI USE ONLY \ se"'i'ftll$\0.rr As.rt€ cr!pB2\5 q.^l^J ur> r{, fru rc-Dra,G f&,*.r P*o(FiG- (z*i'riRJ ,h^/D vt??g"vc- DaPhl+ E66.'-'i'Hi\ oc)T^l-l E^a-.Iild.cro E^^- D-ii,ootOa Balance due:b-Grading Permit: C'R[\-g<3rl lssue Date:Zoning: ?.. 2-2r-?+BUILDING / PTANNING DIVISION : Date