HomeMy WebLinkAboutApplicationGarfield Coang
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Comm unity Development Department
108 8th Steet, Suite 401
Glenwood Springs, CO 81601
19701945-82L2
www.garf ield-countv.com
WPE OF GRADING
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INVOTVED PARTIES
Property owner: RHsrn E o6wu.r Phone: (q10r21q '24+L
Mailing Address
EmailAddress:ftsts*@ etNRtLl-A,. roM
Contractor:Peerqstrs f ,lsTnrn KorneS phone: ttofi 1 4ft0-31\s
Mailing Address
EmailAddress:
Architect:Phone: ( q-lD) 31q- 3-119
Mailing Address
EmaitAddress: fY\OREfa fnN Aqot+1fftc-T . CoM
Engineer:EquE( -R-lsssreK J P. €. Phone: t44l abb-2a*
Mailing Address
Email Address: StrUSS NER @ ANTHCTNETKUCTDKAL . CDNN
PROJECT NAME AND LOCATION
Project Name : t-D6€R LV ResrOpr\n e
Describe Work:6
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Job Address:
Assessor's Parcel Number: Z3c1\972 Olh\ta
Sub Lot Block
Earthwork {square feet}:AVfr Earthwork {Cubic Yards):
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
Authoritv. This application for a Building Permit must be signed by the Owner of the property,
anauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedbythe
Owner, must be provided with this Application.
Legat Access. A Building Permit cannot be issued without proof of legal and adequate a€cess 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 OWIS 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 L80 days of
the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
described above, or
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 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 bythe Building Division. ln consideration of
the issuance of the Building Permit, lagreethat land my agents willcomply with provisions of any federal, state, or
local law regulatingthe work and the Garfield County Building Code, OWTS regulations and applicable land use
regulations (County Regulationis)). 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, 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 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
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 p rovided the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Date
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'i'd6'.oo Fees Paid oo\oo.Misc FeesPermit Fee:eo\m
lssue Date:Zoning:Grading Permit:
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Balance due:g
BUILDING / PLANNING DIVISION
DateSigned
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