HomeMy WebLinkAbout3325 GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
1. PERMIT NUMBER �91Z.6
please print or type DATE /0 77,,6
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS p13� 4 pen. O NOTE: Show easements, property line dimensions,
.a SUBDIVISION Up u C all other structures, specify north, and street
FILING # LOT # BLOCK # name. For odd shaped lots, or if space iS
w TAX SCHEDULE # ton small, provide separate plot plan.
F7 LEGAL (SEC /TWN /RNG) # OF BUILDINGS NOW ON PARCEL 0.1,-e_
,.
Y 1
USE OF BUILDINGS NOW ON PARCEL
NAME :r... di • I ► i rd c e.�
o MAILING AD RES,S _ p �• � �
CITY Ca, PHONE _' ; ,3._W3L1
C4 NAME .....L F.
0 ' ADDRESS CITY
w NAME SQL P Se L w Gi E'[ . T
ADDRESS
1 CITY
PH ONE LICENSE #
0
CLASS OF WORK ) -
r.
NEW ALTERATION ADDITION � C��
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING 95L S.F. OF LOT - .
# OF FLOORS ( HEIGHT g, r `? 10
# OF FAMILY UNITS # / OF BEDROOMS
INTENDED USE OF BUILDING S4 n p a c{ c
GARAGE: SINGLE DBL CARPORT: SIN6 DBL FRONT PROPERTY LINE
FIREPLACE 1 p/ G
DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER
WATER SUPPLY CHECK IF CORNER LOT _
DRIVEWAY PERMIT DESCRIPTION OF WORK PLAN
t/
SITE PLAN 0 1) C NdG-' 57 * , e bin& ,
BUILDING PLANS
SANITARY SEWER CLEARA CE I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building construction
<:, 0 - '
S 4NATURE
FOR OFFICE USE ONLY
VALUATION 9,120.0e FLOOD HAZARD
PERMIT FEE $ gr . YPLAN CHECK FEE $ Z.. 0 CERTIFIED BLDG ELEVATION
TOTAL FEE $2 SCROOL IMPACT FEE $ // if- SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT gie. -. / ,2..1) PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY c rc." S .
TYPE OF CONSTRUCTION ADDITIONAL INFORMATION NEEDED
r,----.., s---
S.F. OF BUILDING S.F. OF LOT
MAX. HEIGHT ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED: ,, 44 iii .rasa /f 7 A - APPROVED:
ILDING DEPARTMENT / D'' PLANNING DEPARTMENT DATE
A