HomeMy WebLinkAbout3789 •, GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT '. ��jj
PERMIT NUMBS '
please print or type DATE 51/0:
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS Ono 7 Aeg4dm , G)apd Road NOTE: Show easements, property line dimensions,
SUBDIVISION JON J,? J4't W/ all other structures, specify north, and street
6 I-1 0 FILING # LOT # / BLOCK # / name. For odd shaped lots, or if space is
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▪ TAX SCHEDULE # ton sma12, provide separate plot plan.
LEGAL (SEC /TWV /RNG) # OF BUILDINGS NOW ON PARCEL CS Wa
▪ NAME trifinnfinflir USE OF BUILDINGS NOW ON PARCEL
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MAILING ADDRESS 43*2 Sp.8,,✓& (A k/
p CITYochgsc • 7 PHONE9I,r Uh -'7197
NAME I. • .1/ I . i
a ADDRESS / () 9 .L., /? CITY i nC4. 60
ec NAME i I) - S ., f : • i , N I
0 ADDRESS /J •
CITY 2f ,C/ f 1 eo /eta
PHONE LICENSE #
CLASS OF WORK
NEW ve ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING S.F. OF LOT i 5 , 4 e gC,
# OF FLOORS HEIGHT
# OF FAMILY UNITS # OF BEDROOMS
INTENDED USE OF BUILDING CAMS f t2Aue/ V ,Je J %CA4W
GARAGE: SINGLE DBL .CARPORT: SINGLE Y DBL
_ FRONT PROPERTY LINE
FIREPLACE
A ) )nG,gdew
DOCUMENTS ATTACHED — STREET NAME /ROAD NUMBER 7'4 k$144 WO0 !CO M
WATER SUPPLY a cfl. p •rte- S-ci r , CHECK IF CORNER LOT v • yE 5
DRIVEWAY PERMIT 6 ` - ' DESCRIPTION OF WORK PLANNED
SITE PLAN ( p,/1 hi,E Lo / /,?, V .2 g ze /•;N . r = . ' J4;
BUILDING PLANS i1 u ' 'd i 1' ' . 12- ' . • 4 : 1, '
SANITARY SEWER CLEARANCE it it— I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT ` w� y . p application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state 1 egulating be}�idirlg construction.
SIGNATURE X.- l�a ®G�W
FOR OFFICE USE ONLY
VALUATION 7,-/ dJ 0 FLOOD HAZARD
PERMIT FEE Sa PLAN CHECK FEE $ ¢¢ ,rtp CERTIFIED BLDG ELEVATION
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TOTAL FEE $ `! .3, to SCHOOL IMPACT FEE $ /r r - Ak SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT 4 /. PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY /2
TYPE OF CONSTRUCTION --Ad ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING 1 . S.F. OF LOT 4 ATE i
MAX. HEIGHT --r.- Ar t ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPE Tr-LINE: FRONT _ OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
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APPROVED: ,2E /,,J/ . 13 6 APPROVED: � �..4 / 3 e
WILDING DEPARTM r / .AT PLANNrF, MEPARTMENT DATE