HomeMy WebLinkAboutApplicationGarfield County
Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
(970194s-82L2
www.ga rfi eld-cou ntv.com
INVOLVED PARTIES
TYPE OF GRADING tr MINORtr MAJOR
Property Owner:
Mailing Address:
EmailAddress:
Phone: ( r'7O )
111L
Phone: (-)A,o |/on n tmContractor:
Mailing Address
EmailAddress:
Architect:
Mailing Address:
EmailAddress:
Phone: (-)fa LJ-+ r^Engineer:
Mailing Address
EmailAddress:
PROJECT NAME AND LOCATION
/32Job Address:
/74
t4,
Earthwork (Cubic Yards):
Describe Work:
Project Name
Assessotrs Parcel Number:
Earthwork (square feet) :
Lot
-
-BlockSub.
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, or
an authorized agent. lfthe signature below is not that of the Owner, a separate letter of authority, signed by the
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 acknowledge that I have read and understan d the Notice and Certification above as well as
have provided the required info n which is correct and accurate to the best of my knowledge.
4
and Sign Date
r
readthisApplicationandthattheinformationcontainedaboveistrueandcorrect. I
ng Division accepts the Application, along with the plans and specifications and other data
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
Iaw 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 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 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 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 certify that I have
understand that the Buildi
submitted by me or on mY
dOFFICIAT USE ONtY
itionsi Eia(Q(rJc-- Af'tt€ cr2pN Ftr's cuJtJ P$'<
str-t'c\&* PAfun<f fe-r$rN(r- E€=u\€Ll - QvSf /o/b
Special Cond
uaee) dor.l gn:oU, R€4rerGte$
Fees Paid:d'Total ooMisc Fees:OO
Zoning?.lssue Date:Grading Permit:
-3q
Balance due:
t6.2-Z+
BUILDING / PLANNING DIVISION
Date