HomeMy WebLinkAboutApplicationl
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
(970194s-8212
www.garfield -counW.com
TYPE OF GRADING
tr MAJoR EI MINoR
INVOTVED PARTIES
\ c\r." .\f a 4.D 5rn Phone: @oa l7L7 qLoTProperty Owner:
Mailing Address:00c(I LO t
EmailAddress:t1" 4
Contractor:Arl\Phone:6'h )6tt l'.11ir
Mailing Address
EmailAddress:
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Architect: I "rlv-<-Phone: (
Mailing Address
EmailAddress:
Engineer:Phone:b 2>
Mailing Address:
EmailAddress:
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PROJECT NAME AND LOCATION
Project Name 0l* t.'.-9rt
Describe Work: Llzavt
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I bir 6vJ5 uJob Address:
Assessor's parcel Number: 2l tS Z b l\ 3 o L b
Sub c rot 2b Block
Earthwork (square feet):o Earthwork (Cubic Yards): 6 t'o O.l. VtaAt
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,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 th'e Application, along with the plans and specifications and other data
submitted by me or on my behalf (submittals), based upon my qertification 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, except for residential uses, are subject
to Article 7 of the Land UEe ond Developmcnt Codc. I ocknowlcdgc that thc Building Pcrmit may bc suspcndcd 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 worl< 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 provi the required information which is correct and accurate to the best of my knowledge.
2.
r Print and Sign Date
OFFI ONLY
specialconditions: Ceal.o$[r Al-'-t'o-t>-r.,rrJr:J Yt>t,c-. F.rr.-D,rxrG@r..^,<r-
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Permit Fee c2c)\ oc)
Misc Fees ooTotal Fees:loo Fees Paid:
Balance due Grading Permit:
d^?$\.thbL
lssue Date:
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Zoning:
S- ro -L4BUILDING / PLANNING DIVISION
Signed Date