HomeMy WebLinkAboutApplicationGurfuId County
REC Development Department
108 8t Street, Suite il{tl
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Contractor:
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Engineer:
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ALL UTITITIES MUST BE LOCATED FRIOR TO ANY GRADING
J NOTICE
Authoritv. This applicaticn for a Euilding Perrait must be signed by the Owner af 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 Applicaticn.
Legal Access. A Building Perrnit cannct be ixued without prcof of legal and adequate access to the property for
purposes of inspections by the Building Division.
g[he1Berulg. Multiple separate permits may be required: {1} State Electrieal Permit, (2} County OWTS Permit,
t3) another permit required for use on the property identified above, e.g. State cr County Highwayl Road Access or
a State Wastewater Discharge Perrnit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 18O days of
the date of issuance and if work is suspended or abandened for a period of 180 days after commencernent.
CERTIFICANOil
I hereby certi{V that I have read this Application and that the infornration contained abovs is trr:e and correct. I
understand that the Euilding Division accepts the Application, along with the plans and specifications and other data
submitted by me or on my behalf {subrnittels}, based upon my certification as to accuracy. Assuming completeness of
the submittals and approval of this Applicatien, a Building Perrait witl be issued granting permission to me, as Owner, to
construct the structure(sl 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 agentt wif I ccmply with provisions of any federal, state, or
local law regulating the wsrk and the Garfield County Building Csde, OWTS regulations and applicable land use
regulations {County fiegulation{s}}. All County development requiring a permit, except for residential uses, are subiect
to Article 7 of the Land Use and Development Cade- I acknowledge that the Building Perrnit may be suspended or
revoked, upon notice from the County, if the location, construction or use of the $ru€ture{s} and facility{ies}, described
above, are not in compliance with County Regulation{s} or any other applicabl* law-
I hereby grant permission to the Building Division to enter the prcperty" described above, to inspect the work- I further
ackncwledge that the issuance of the Suilding Permit does not prevent the Building Official frorn: {1} requiring the
csrrection of errors in the rubmittals, if any, discovered after issuance; or {U stopping {onstruction ar 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 i*spections of the work by the Building Division do not constitute an acceptance
of responsibility or liability by the Csunty of errsrs, omissions, or discrepancies" Al the Owner, I acknorrledge that
responsibility fcr compliance with federal" state and lscal lan s and County Regulations rest rryith rne and my authori?ed
agents. including whhout limitation my architect designer, engineer andl or builder.
I hereby *cknowledge that I have read and und€rstand the Notice and Cerlification above as w€ll as
have provided the r€guir€d inforrnation which is correct and accurat€ to the best of my knowledge.
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Propefi Owner Print and Sign
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Date
OFFISALUSE OITIY t
Special Conditions:""e;C;pC,W^f""0- a,-rsl %>K. T3uruDrt Cr f,bur^,'i- PxvU"rG
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Permit Fee:\no cF)
Misc Fees:Total Fees;\oo clc,l Foes Faid:
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Balance due:t Grading Permit:
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lsrue Date:lcningY
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6 -7-24
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