HomeMy WebLinkAboutApplicationGarfield County
{'"' CommunityDevelopmentDepartment
108 8rh Street, Suite 401
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TYPE OF GRADING
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PROJECT NAME AND LOCATION
INVOLVED PARTIES
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Mailing Address:
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Engineer:
Mailing Address:
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Project Name
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Assessor's Parcel Number
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Describe Work:
Block
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, o
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.
VoidPermit' ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80daysof
the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
lh ereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the requ
Kc^'tft' Ul ation which is correct and accurate to the best of my knowledge.
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DateProperty Owner Print a Sign
by 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 Regulation(s)). All County development requiring a permit, exceptfor 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 Building Officialfrom: (1) requiring the
correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use of the
structttre{sl or facilitvlipcl if crrrh ic in rrinlatinn nf fnr rntrr Racr rlr+innle\ nr rnrr nrhar r^^li-.hl^ 1r.., Da.,i^.., ^s +hi^u},lJrruuvrL ruvv. trLvt!ve vt ttil5
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
resnonsihility for cnmnliance with fede!.a!, state and loca! !aws and Count,; Regu!:ticnc r"oct with mc anC m.; authcrizcd
agents, including without limitation my architect designer, engineer and/ or builder.
I here
OFFICIAL USE ONLY
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Balance due.e Grading Permit:
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EUILDING / PLANNING DIVISION
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