HomeMy WebLinkAboutApplication- Garfield County
Community Development Department
RI=Cr_I%. 108 g"' Street, Suite 401
Glenwood Springs, CO 81601
AUG 16 202'(970) 945-8212
www.earfield-countv.com
TYPE OF GRADING
® MAJOR
INVOLVED PARTIES
❑ MINOR
Property Owner: CAL LL -Phone:( 970
Mailing Address: (q oZ W s b;,, � Qf I�✓,� �1g"r•U &Biel c., le) s i C Q 6-a i
Email Address: byi re E4
Contractor: _... Pr,
el, �J; n*c .
Phone: ( 916 9963 —
Mailing Address:
0- 011?
gy ✓A/f
6 11Z ",lei 00d o I
Email Address:
c L,�.
c, ✓er,
Architect:
Mailing Address:
Email Address:
Phone:
Engineer: c i, a„*., v
g- � n�' n QF ,,n G � Phone: (% i O ) Q �}
MaiIin Address; (S1 1 �]�yF;nv* E S.„ r 4
g � f [D) ,-Ic✓���� SSA cn �r60j
Email Address:
PROJECT NAME AND LOCATION
Project Name: S ;
Describe Work: r +A. /G� �s v�b7 ��+�f� �-+i"`*S'!/✓LC/ )//c)� Cq•
i L, e C , � -1e T V'X OS ✓ yid j�L�-,�+nn ✓ f 771 °`w'+--� .
�Y+;s we✓�5 exGlindcs 4-Incw�4..rC LA�a��i i—y-Lsey u.,Ik 1U r
Job Address:
be fwIk,^�"`1 l
Assessor's Parcel Number: i 0 �# C, d �� 1
Sub. Lcx, Af^;Lot e S -4 P-14 tt I Block
Earthwork (square feet): 2-7b , o o c) S F Earthwork (Cubic Yards): I o,,55.3
r~l�fs,
ALL UT(LiT(ES MUST BE LOCATED PRIOR TO ANY GRADING
I NOTICE
Authority. This appiicatlon for a W-1ding Permit must be signed by the owner W. the property, dmcribed abo", or
an authorl7ad agent. If the itgnature Wow Is not That of the Owner, a separate letter of autl►ority, signed by the
Owner, must he provided with this App6katlon.
Ia"(e5s, A guildiog Permit rarmw tit issued withau4 proof of legal and aeAquate access to the property for
: purpo%es of inspttitiom by the 9014mg Mvision,
t) : errnits• Multiple separate permits may be required: Ill State Electrical i+urmit, (21 i:ounty OWTS Permt,
f3f another permit required for me on the, prpperly identified above, e.g_ State or County Highway/ Roam Aeceso or
o State Wastewater 08charge perrtrit.
Void Permit. A S&Jding Permit b000mcf null and void If the worlt authodied is nut commenced widtin -180 days of
the date of issuance and if work is suspended or abmndo ted for it period of JR0 days after snmanencerwvnt,
CERTIFICATION _
I iw reby cxrtify that l have read this Application and that the Infarmat1on contaibed above Is true and correct. f
understand ;hat the Ruitiirog ❑ivislan accepts the Application, along with the plans and spmJfications and other
data subinit,ted by ine or an my hehalf tsarbmittalsl, band upon my certificatlon as to accuracy. Assuming
cwn fArneaess of the sljWr itta4s and approval of this Application, a Bolding Permit wltl be issued grAnting
permisslon to me. as Owner, to coraruct the strucwrciil and facilities 4gt4ilrfcl on ilia Tubmlttals reviawed by the
Building nivisinn. In consideration cat the issuance of the SulldmR Permit, f agree that I and rrry agents will comply
with prouisionx of any federal, state ar lacal law ficSuidtipg tleewwk and the Garfield Cgsrnty auildingCodq, OWTS
egulaLlant and applicable I, nd ugc regub3tions (County ftnulat6;mt(s)), I acknowledge that the f}Vildin� Permit
may be susiperWed or revoked, upon notke from the County, if the k%ation, omistrtrttion or use of the Structure(%)
and facllitytiesj, described above, are 41ot In complence with County Regulaiian(s) or any otlsw applicable law_
I hereby grant permission to the ouirding piw-$oa to enter the property, described above, to iW4Wct the woek_ I
further atfcnowledge tlxat thr i-;5wince of the Building Permit dcaes not prevent the Br. Wing Official born€, (1)
requIriag the correction of errors in the wbmittals, if any, discovered after issuance: of (2) stafrping corts4ruttion
or use ar the strvctur+ qj ar fadliMivs) if ruch Is in violatipn of Cnwmy Regrutatiantsl or any other appfk;ahrF lam,
Review of this Application, Including subrtsattals, and lne pectlons of the work by the Bullding alvision do not
canstatute an acccptarc .. u4 rc;panti"bility or liability by the County of errors, nrnisskans nr discrepaendes_ As the
1 Owner, r a4knowledge that responsihiltty for tamrrllanw with federal„ state and local lours and County Regulations
rest with rive and arry autho€iced agents, indu+Ding wltltout limitation, eery architect desfgnef, engineer andl or
Wider,
I Hereby, acknowledge that I have read and understagtd the Notice and Certi#icatfun above as well as
have provided the required i-Aith i% 1961; tt andl necurme to thg best of ray knawledgr;.
PropMy Owner Print and
OFFICIAL USE ONLY
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