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HomeMy WebLinkAboutApplicationGarfield Coanty GRADING PERMIT APPLICATIONRf Cf ruftlnmunity Development Department 108 8th Street, Suite 401 AUt; 1 3 ?U24 Glenwood Springs, co 81601 (9701945-8212 G l\ f{ f: I E L D C 0 u N },hw.earfi etd-countv.com { nt/i, I Ui{i f Y DEVE!_ )PMh- tr MINORtr MAJOR TYPE OF GRADING Contractor:MiLe 5cri.,o,*+Phone:(?70t37b'15q3 Mailing Address: P.o,%nx VftS A*^ Co S/A)o EmailAddress . t4,Lo @ Lrq^aw e4lr ewl*rr,, Jl a^, co vtA Earthwork (square feet) : O- 2"1 ) 3q 1 )o4 01/ o )"1Assessor's Parcel Number i<t ( a(( 1o,,., Ulun,sua. /]fup.er Job Address: Project Name: *9 Lot <I ilkfi^V, L^^n- uJ S) 4lL Trn.K Earthwork (Cubic Yards) : Block Describe Work: Av/ PROJECT NAME AND TOCATION C-o vt4 tl oo5 o6Tru Phone: n ZO) "/.,7-L5 V3Engineer: Mailing Address: EmailAddress: o )(hone: ( 5,,, Architect: Mailing Address: EmailAddress: owner: p.;[ce €cni tn -9 Phone:Property 376 _ 6s43&70t X VOo Email Addre tt, M;[-e wd€l (on*rctcl ictt ' co t't't Mailing Address: INVOTVED PARTIES 9"L ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING NOTICE Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,or an authorized agent. lt the signature below is not that ot the Owner, a separate letter of authonty, srgned by the Owner, must he 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 andvoidiftheworkauthorizedisnotcommencedwithinlS0daysof 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 otherdata 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 Regulatron(s)). nll Lounty development requrnng a permrt, except for resrdentral uses, are sub';ect to Artrcle / of the Land Use and Development Code. I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if thc location, construction or usc of thc structurc(s) and facility(ics), dcscribcd abovc, arc not in compliance with County Regulation(s) or any other applicable law. lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. lfurther acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1) requiringthe 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 responsibilityorliabilitybytheCountyof errors,omissions,ordiscrepancies. AstheOwner, lacknowledgethat 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 providpd the required information which is correct and accurate to the best of my knowledge. -'M--- {^t3 t'l Property Owner d Sign Date BUTLD|NG / PTANNTNG D|VTSION : g.L3.z4 Dateed Grading Permit:Balance due: ooooFee:Fees PaidTotal FeesMisc Fees: lssue Date:Zoning: OO sPeciai conditions: G{?}o\F{,: e\- nE uLJFJetoJ q,^l r.} Pt S r<, 7u,. brxrC>. Pofr.,rA 76^tS,*fr- (alreX>, )u5T- ,loFr}, r^'e@ &rt'lvt-ot.- p<),,.rr ?*:D f"rt t > ggsrtracfpr"l 5v6l-ri\rsb t^, rftt Ttrc- ft+ra-r+*r oFFrcrALusEoNL!+h N0\ fl t tl 4.334 8+3-31