HomeMy WebLinkAbout3874 ' GARFIELD COUNTY G: , - ;
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER 7/
please print or type DATE Ar; 0
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS N5' W rAAAA-CA -t* NOTE: Show easements, property line dimensions,
SUBDIVISION SollyDI EEgtt d VILLAt r # I all other structures, specify north, and Street
FILING # / LOT # / BLOCK # name. For odd shaped lots, or if space is
w TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) # OF BUILDINGS NOW ON PARCEL
NAME (54174 OF BUILDINGS NOW ON PARCEL
NA
(5417L rft i. r *, PT 4 P4 -q.,%
MAILING ADDRESS 'p p, .haw anon
CITY )/ AllEm oat A.4 SA PHONE xBsr.Q,00
7 a NAME -row HEAL ..
S ADDRESS Zmk1 t CITY rp
NAME SAiruceN *Ai t- A.M nag act," n . r
ADDRESS 'g e A,S,C
CITY f34.rtyj,M (rev r AA ESA Co
g 'PHONE 7 - 7 3( LICENSE # AI /41 I dam/
CLASS OF WORK
NEW }[ ALTERATION ADDITION 7C
DEMOLISH REPAIR _ MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING S.F. OF LOT
# OF FLOORS HEIGHT
# OF FAMILY UNITS # OF BEDROOMS
INTENDED USE OF BUILDING c & Ge
GARAGE: SINGLE DBL CARPORT: SINGLE DBL
FIREPLACE � FRONT PROPERTY LINE
DOCUMENTS ATTACKED STREET NAME /ROAD NUMBER
WATER SUPPLY CHECK IF CORNER LOT _
DRIVEWAY PERMIT Ade b ei) i u ne 'Li DESCRIPTION OF WORK PLANNED Amp ,/,mow
SIT4 PLAN ter' GArtAer ft. de & 44, la � � � .4-. g nit";;
BUILDING PLANS , 4- "7e A0 t µ [R2
SANITARY SEWER CLEARANCE I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT _ application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
allai . and state la re ulat�uil ng construction
SIGNATURE(
FOR OFFICE USE ONLY
VALUATION 440100.0 0 FLOOD HAZARD
PERMIT FEE $ y!.), S p PLAN CHECK FEE $ /,t a p CERTIFIED BLDG ELEVATION
TOTAL FEE $6 SCHOOL IMPACT FEE $ SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT PROBLEMS WITH PERMIT _
TYPE OF OCCUPANCY 11
TYPE OF CONSTRUCTION ArnAp h7c ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING 9O O S.F. OF LOT c„.:75
MAX. HEIGHT /FAQ..}. -- ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT $' ) OR ENGINEER -
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
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APPROVE , , r. /� I�i / /�� , ' . (0 APPROVED: z�/
:UILDING DF'AR E SAT: P DEPARTMENT D ATE