HomeMy WebLinkAbout3661 M . GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT // f
PERMIT NUMBER J�fi'i g
please print or type DATE J�z
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 33 9d(, #/ 4u / - e t � NOTE: Show easements, property line dimensions,
a SUBDIVISION / all other structures, specify north, and street
FILING # LOT # BLOCK # name. For odd shaped lots, or if space is
a TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) # OF BUILDINGS NOW ON PARCEL 2
NAME USE OF BUILDINGS NOW ON PARCEL 411 f1$',{p �e
p MAILING ADDRESS A o% 0 2 9
o CITY r/ 1 i C„ _ PHONE f/( -„2
m NAME A/Q /v(7 G✓A'-..rek oJ- setn'2J- ,
i ADDRESS ' rr CITY e r S
x NAME r}'t( 4, ✓
1 ADDRESS
CITY
(PHONE LICENSE #
CLASS OF WORK
NEW ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make/model)
S.F. OF BUILDING 14400 S.F. OF LOT gars
# OF FLOORS / HEIGHT
# OF FAMILY UNITS /V6,19 # OF BEDROOMS 44/0"e_
INTENDED USE OF BUILDING 5s / F S'.{e r a.F�
GARAGE: SINGLE DBL CARPORT: SINGLE u bBL . FRONT PROPERTY LINE
FIREPLACE
DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER 05 p.J/ W 4 d-.21/
WATER SUPPLY lk t lA CHECK IP CORNER LOT _
. DRIVEWAY PERMIT p." a .../., •p DESCRIPTION OF WORK PLANNED ri , i * d.
SITE PLAN Stile' - st/ C/or -A�.e . Ao. /s /.. :h /t A k t
BUILDING PLANS Y� s . " _ . 1
SANITARY SEWER CLEARANCE il04 I.hereby acknow edge th I have red./ this
ON SITE SEWAGE DISPOSAL PERMIT .3 application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state regulating building construction
�.� AT
i9 e
ATURE
VIC FOR OFFICE USE ONLY
VALUATION ¢D 5 , A n FLOOD HAZARD
PERMIT FEE $ ]42,SOPLAN CHECK FEE .$ .C„17 La CERTIFIED BLDG ELEVATION
TOTAL FEE $ 4-0p,[d SCHOOL IMPACT gEE $ SPECIAL CONDITIONS
DATE PERMIT ISSUED J
ZONING DISTRICT 4-frier PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY a la 0-
TYPE OF CONSTRUCTION V'-A/ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING b..c S.F. OF LOT
MAX. HEIGHT .A•- 13 ' ROAD CLASS.,— CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT A 4 OR ENGINEER .
REAR RIGHT LEFT "'
OFF STREET PARKING SPACES REQUIRED.--r
APPROVED: / �f , .' ���_� /.�� . �b APPROVED: / r " �'r a
Orr DING DE•A• EN' o, DA' PLANNING DEPARTMENT DATE
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