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GARFIELD COUNTY
n APPLICATION FOR BUILDING PERMIT
M ` PERMIT NUMBER 2 33/4 7 .
please print or type DATE /2/9/t7
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS /4 t,2 � 2S CAe NOTE: Show easements, property line dimensions,
, SUBDIVISION / dt 7,, g/tie all other structures, specify north, and street
FILING # LOT # BLOCK # name. For odd shaped lots, or if space is
a
TAX SCHEDULE # / w�.r too small, provide separate plot plan. / "
LEGAL (SEC /TWN /RNG) 47/» - Z/447 j 4Jq um # OF BUILDINGS NOW ON PARCEL 3 u 't (.0n
- � USE0F BUTL INGS NOW ON Caw a `
NAME p 5 r c/ C C f— C� ..7 joy
6 fs7 MAILING ADDRESS _
CITY _ PHONE 963. 3600 A /.E'er` & -- f w.rtl1a /c'`c B9e&
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NAME - ei-nra ' A' sAkm- X: Tan TZ'�t T g i.e/ I /
■ w ADDRESS CITY 7 /O p c 5 . � / ® /.U' .
• NAME 'j7. ft 1 . / 67.)M C . _'. 4 Cr.
ADDRESS On 413 1•\\, MCx A Ibv.] / Hi LJ et -
CITY C' tEAl S#'6 <- Co-
g (PHONE Z¢$t 75',7 Z- LICENSE 1.+
CLASS OF WORK
NEW ALTERATION n ADDITION
DEMOLISH REPAIR __ MOVE
MOBILE HOME (make /model) _
S.F. OF BUILDING 7200 S.F. OF LOT
# OF FLOORS HEIGHT
# OF FAMILY UNITS # OF BEDROOMS 7—
INTENDED USE OF BUILDING ;16&`#Ce- /- iO/ry /C y
GARAGE: SINGLE DBL CARPORT: SINGLE DBL FRONT PROPERTY LINE
FIREPLACE ,/ /, ---- ,ECG,'Ci¢G /�
f DOCUMENTS ATTACKED STREET NAME /ROAD NUMBER ,11 8 2_
WATER SUPPLY Al0 /=: CHECK IF CORNER LOT _
DRIVEWAY PERMIT //A^. DESCRIPTION OF WORK PLANNED
/` f}-
SITE PLAN /' f ', 'e -e 4 t € /-4:704
�
BUILDING PLANS / t,a9— ✓
SANITARY SEWER CLEARANCE / P /Q /-7- I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT /l/'A _ application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building construction .
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SIGNATURE
FOR OFFICE USE ONLY
VALUATION / / ,, G ° ° p'» - 41.0--FLOOD HAZARD
PERMIT FEE $ 72 2,ScPLAN CHECK FEk A/11- CERTIFIED BLDG ELEVATION
TOTAL FEE $ /2,2,ca SCHOOL IMPACT FEE $ SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT in L..f _ PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY /e — /
TYPE OF CONSTRUCTION Y -4/ m N ✓ / 4 7 ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING Un 161Q „ S.F. OF LOT At A-
MAX. HEIGHT tf.-yff,.,cWi ROAD CLASS. A/ /,� CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LANE: FRONT Al OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED `� �j' ] `� �� _ �Q
APPROVED: d� / //, a d _ 11 ,e ki .2S s APPROVED: ♦ e `_ l /`V 7
: ILDING DEPA ', DA t. PLANN G EPARTMENT DATE