HomeMy WebLinkAboutApplicationGarfield County
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Community Development Department
108 a Street, Suite 401
Glenwood Springs, CO 81601
(970)945-8212
w►tirwaar&eldcountyco.gov
TYPE OF GRADING
❑ MAJOR
INVOLVED PARTIES
MINOR
Property Owner:
Phone: 5( 1 Z) l i`'I " G51 11
Mailing Address: P56 -T YZ-
zd 194. z
Email Address: Y511n.1411 w.A"
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Contractor. K0
&, d Phone: (k SIT - ?'161
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Mailing Address: Ao r z
e"D gib-5 v
Email Address: r ' z,—;) boil �tsr.�lc ca•.
Architect: A,,,
Le,
Phone: 356 -
Mailing Address: - �[� _ &E 0/1 g
S16 2,1
Email Address: ^ e-0 ► fx..rd.,
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Engineer: k
LL& Phone: 3"' ' 169
Mailing Address: 7-TA rlOvn r, aloe-
LK
e-LE-1 ru... ..w� Go
Email Address:
PROJECT NAME AND LOCATION
Project Name: eg- 1m
Date of Completion:
Description of Work:
Job Address: 63 C
4- 64 Sst65�
Assessor's Parcel Number: 21 K 3 51yy 31 S
Sub. `-r, "?5; ?,' Y.,Lp : 6 � 4nt, : lfl AW16
Earthwork (square feet): , 1. ZSD
Lot
Block
Earthwork (Cubic Yards):
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE described above, or
Auti►ority. This application for a Building Permit must be signed by the owner of the property,
all authorized agent, if the signature below is not that of the Owner, a separate letter of authority, signed by the
Owner, must be provided with this Application.
l.etta)-Access. A Building permit cannot be issued without proof of legal and adequate aiccess to the property for
pu 0Oses of inspections by the building Division.
Cither permit,, h"ttitiP;e separate permits may be required: (1) State Electrical Permit,12) County O load permit,
or
i' ] another• permit required for use on the property identified above, e.g. State or County Highway)
a State Wastewater Discharge Permit.
Vold Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days o
the date of issuance and if bvork 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 cantlans and sained ve is true and e� fcation and other )
understand that the Building Division accepts the Application, along with the p P
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 structures) and facilities detailed on the subrnirtalsnets ww by the
Building Division. In consideration of the issuance of the Building permit, I agree that I and my age
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 Regulation(s)). Ali County development requiring a permit,
except for residential uses, are subject to Article 7 of the band 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 compiiance with County Regulation(s) or any other
applicable law.
I hereby grant permission to the Building Division to enter the properly, described above, to inspect the wor
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 we as
have ro hied the required information which is correct and accurate to the best off my knowledge.
!
Date
Property Owner Print and Sign
OFFICIAL USE ONLY '(,�€. -S
Special Citions:
ondad.t,/IDt-r,0t,) µ�(
I" gee•
Balance due:
Misc Fees:
Grading Permit:
�TotalOGFeesPaid: Date: Zoning -
issue
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BUILDING / PLANNING DIVISION: Date