HomeMy WebLinkAbout3740 „_ A GARFIELD COUNTY
_ APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER 3 7 r
please print or type DATE ; . Ag
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS NOTE: Show easements, property line dimensions,
SUBDIVISION 1 C j, s, ,- /s . M /all other structures, specify north, and Street
FILING # LOT # /. BLOCK # name. For odd shaped lots, or if space is
TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) _ • _o. fflP # OF BUILDINGS NOW ON PARCEL O
pq NAME ; USE OF BUILDINGS NOW ON PARCEL
M a
w MAILING ADr"ESS Wet/ r w
CITY , ,. ' ”
. PHONE ; .� -. , '
eof it i
NAME
i R ADDRESS CITY c
-
s NAME ,OU)/I n? a�C-L-I T _ a� ---,' N
ADDRESS "lP O
CITY Q. 45N 0
4 0
PHONE LICENSE # 1-11-
CLASS OF WORK
NEW /�' ALTERATION ADDITION ...... --
DEMOLISH REPAIR MOVE .,G®a ' / <-----)-
-1.5t1 -1.5t1 MOBILE HOME (make /model) ��� - -�•�- ....... -
S.F. OF BUILDING ip90 S.F. OF LOT j •;.L^'[�'� ( rS e
# OF FLOORS / HEIGHT
# OF FAMILY UNITS / # OF BEDROOMS , J p p
INTENDED USE OF BUILDING Re'a� 1 r/ r ra r �Q rDCZa / � � �� 1 A /' � /' �O . ] t�
GARAGE: SINGLE DBLA ARPORT: SINGLE DEL og r cr 1lOPERTY LI a Il" 744
FIREPLACE �/� tt
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER . j/ . /,1 Or,
WATER SUPPLY Chili p tL "/fr CHECK IF CORNER LOT
DRIVEWAY PERMIT DESCRIPTION OF WORK PLANN Lc
D e/ ,
SITE PLAN ft��� 4er.11 Slid" � 1 rrli / :1" /ZFp�rad/17
BUILDING PLANS t,...-e ,
- /7DrP. (�
SANITARY SEWER CLEARANCE I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT 71d 40[ S u application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
antate laws regulating building construction.
SI NATURE
lir A FOR OFFICE USE ONLY
T
VALUATION pr ..�0 .O O FLOOD HAZARD
PERMIT FEE $ P LAN CHECK FEE $ CERTIFIED BLDG ELEVATION
TOTAL FEE $�gS SCHOOL IMPACT FE $200400 SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT „ ! 2 1 4, I PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY A7 3
TYPE OF CONSTRUCTION y— ^/ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING 2 /$ S.F. OF LOT
MAX. HEIGHT /5 I6tq ROAD CLASS CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY<LINE: FRONT` OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED /� I /np, /, ]
APPROVED: .,.., r . a ✓..w ! 3 G 6 » /L ./��1 �l `. L
BU II G DEPA _ �4 / TM T D''E PLANNING DEPARTMENT DATE