HomeMy WebLinkAbout3627 . A ,LiTY - OR APPLICATION FOR BUILDING PERMIT PERMIT NO OP
- COUNTY x BUILDING DEPARTMENT DATE
TO BE FILLED OUT ay APPLICANT PLOT PLAN
NOTE: Show Easements, Property Line Dimensions,
VALUATION TOTAL FEE All Other Structures, Specify North, and Street
Name. For Odd Shaped Lots, Provide Separate
:LDC ADDRESS 178 Sagamont Cirr Plot Plan.
..1 H UBDIVISION Monument Creek Village No. of Bldgs now on Parcel 0
0 V FILING NO LOT NO ?A BLIP NO 15 Use of Bldgs now on Parcel NSA
. W TAX SCHEDULE NO 490210 -
4 y
m
AME Evans, Mary & Charles _ Plan #6 Ponderosa m
.IL ADDRESS PO Box 536
ITY Basalt. Co. 81621 PHONE 927_3864 Garage expanded to 22 X 26 M
Covered Patio 15 X 8
14 AME Daniel Brodsky Owner Greenhouse on Found. 16 x 7 en
ti •IL ADDRESS 5701 N.19th Ava Two (2) Gas Fireplaces
, C7 IT Phn enix, Ari9
51
AME SUNDANCE BTTTT,DERS, INC SEE ATTCHED PLOT PLAN b
o .DDRESS Tamar Tra #111
ITY Parachute. Colo. 81635 y
ICENSE NO PHONE 2R5 - 7554 Po
• O b
CLASS OF WORK M M
NEW ' ALTERATION ADDITION H "C
DEMOLISH . REPAIR MOVE M
OTHER Owner aree Liman -to n Rg7r
Sq Ft of Bldg 16413 Sq Ft of Lot 9637 Mi
No of Floors 1 Height 16
No of Family Units 1 no of Bedroom 3 '
Intended Use Building Single Family Residence
FRONT PROPERTY LINE
GARAGE X CARPORT
Single Oble X Single Dble FIREPLACE 2 (}ay Street Name(s) Sagemont Circle
"'— Check if Corner Lot No
DOCUMENTS ATTACHED Description of Work Planned: Single Family Res.
Radon *urvey Frame Construction with ov•r ize .... :
Driveway Permit _ Classed In Greenhouse attached to rear of hewn,. •
Site Plan Attached Covered Patio. '
Building Plans Attached I Hereby acknowledge that I have read this
Sanitary Sewer Clearance l if/C application and the above is correct and I agree
On Site Sewage Dis»osal Permit NA- to comply with all city and county ordinances
Fire Flow Survey /try and state laws regulating building construction.
Health Department , NOTE TO APPLICANT: Reverse side of this form
164-1 �j must be completed.
I C a, e 33! . 0 : ( e �-6C 1. /17,,,w. ,-----
_ Q en.L ,..re . otirIP 5. — ' - 'fit VD SIGNATURE
FOR 6F'FICE USE ONLY
k czr rO739e0* peG `�= _ - .
Date Permit Issued „Flood Hazard Wildfire Hazard
Zoning District ” L /i- : . •ic Hazard Other
Type of Occupancy ' r ; _ pecial Conditions
Type of Construction r
Sq Ft of Bldg 2:;;4 Sq Ft of Lot 9..9u'. Problems with Permit
Max Height --L.- Road Class.
Center of R.O.W. Setback Additional Information Needed
Ft Yd Setback from Property Line .
Side Yd Setback from Property L in
Rear Yd Setback from Property Line , Approval Date Bldg Dept By
Off Si - - t Parking Required_ /! 7 �� Approval � Da Planning By ;(1,91„..6;____ llhary