HomeMy WebLinkAbout3376 GARFIELD COUNTY 7/07
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER f
please print or type DATE .s IJ
TO BE FILLED OUT BY APPLI N PLOT PLAN
ADDRESS / cestrunis, NOTE: Show easements, property line dimensions,
SUBDIVISION all other structures, specify north, and street
5 FILING # LOT # BLOCK # _ .name. For odd shaped Lots, or it space is
a TAX SCHEDULE # Zf7 -. 0 - C U - 032— too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) ,r, # OF BUILDINGS NOW ON PARCEL
NAME _,/ USE OF BUILDINGS NOW ON .PARCEL �et,5 j p p
p CITY IN ADDRESS , S/iI I � ,`.A 9.4y �/J
NAME t C OS L a in , to 4L o / ( fi n 7 /
6 r
I ADDRESS G ?h a., CITIQre/1 a) x NAME 4,1 as L :_lri W _ ��
F
ADDRESS y ill .�7 '
C CITY �wl� � /
g ( P HO NE _if'Sr. ' LICENSE #
CLASS OF WORK .
'y 4
NEW ALTERATION _ ADDITION /[Y"� Jy' /O ,,
DEMOLISH REPAIR MOVE
MOBILE HOME (make/model) 2 5 0
S.F. OF BUILDING / f h 6 S.F. OF LOT
# OF FLOORS HEIGHT 9 -
# OF FAMILY UNITS # OF BEDTMS am � a,-8 _`k. '
INTENDED USE OF BUILDING ?-u"" l�1(Jebc� -- X." vex ,------- _1
GARAGE: SINGLE DBL CARPORT: SINGLE SLR T DBL a ONT PROPERTY LINE
FIREPLACE [r.`
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER X900(
WATER SUPPLY ,,,e CHECK IF CORNER LOT
DRIVEWAY PERMIT � DESCRIPTION OF WORK PLANNED
SITE PLAN
BUILDING PLANS
SANITARY SEWER CLEARANCE 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.
SIGNATURE
/ FOR OFFICE USE ONLY
VALUATION., I 3 /) FLOOD HAZARD
PERMIT FEE $ 1 PLAN CHECK FEE $ 441 4/7 CERTIFIED BLDG ELEVATION
TOTAL FEE s /Q, %, /Q SCHOOL IMPACT FEE $ A lfa SPECIAL CONDITIONS
DATE PERMIT ISSUED /
ZONING DISTRICT , /,ie4 � 4 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY 2,3
TYPE OF CONSTRUCTION y,(/ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING /g S.F. OF LOT
MAX. HEIGHT /3' ROAD CLASS. `---' CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT ----_, OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED . _
APPROVED: e . , , , , . j ,e / � / i a w l I A/ ( A.�i� { 'Nr.� 3/
/
l ' IILDING DEPT "TM „ , D';E PLANNING DEPARTMENT DATE