HomeMy WebLinkAbout3900 r ,. • GARFIELD COUNTY
r"' APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER ci
please p int r type DATE 3`�J`9
2 2.
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 07& c,f-j, / /Z— NOTE:. Show easements, propert line dimensions,
SUBDIVISION RRcpI3 all other structures, specify north, and street
FILING # LOT # Z.. BLOCK # ____r name. For odd shaped lots, or if space is
w TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TWIN /RNG) # OF BUILDINGS NOW ON PARCEL -f
N AME a USE OF BUILDINGS NOW ON PARCEL
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R MAILING • c O , c PHONE 63 a7 y
NAME O I co
1 P `' ADDRESS5p, LZet, CITY _��'S {0.-
p NAME i
G ADDRESS 4. _
CITY . r.: be .21 . CP
PHONE q /µ3 -Q0 y LICENSE #
V
CLASS OF WORK
NEW 20 ALTERATION ADDITION
DEMQLISH REPAIR MOVE t
MOBILE HOME (make /model)
S.F,. OF BUILDING (S'0 S.F. OF LOT S A
# 01 FLOORS 2- HEIGHT :0 - #�„
# OF FAMILY UNITS + # OF BEDROOMS 3
INTENDED USE OF BUILDING .5,4 Z.
GARAGE: SINGLE DB CARP T: SINGLE DEL FRONT PROPERTY LINE
FIREPLACE -The /y /
DOCUMENTS A TACIIED — STREET NAME /ROAD NUMBER �.to r/ Z-
WATER SUPPLY wed( CHECK IF CORNER LOT
DRIVEWAY PERMIT A/* DESCRIPTI9N OF yoRK PLANNED
SITE PLAN ✓ 0/9774-4r fr S* e
BUILDING PLANS v
SANITARY SEWER CLEARANCE VA' I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT tri,C L6(c %G1, application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all unty ordinances
a sta(' aw 'ng wilding construction cit
SIGNA l\ 7 E
-2_2_7 l ter, he < QS - s C/n ?% FOR OFFICE USE ONLY
VALUATION t9 ? o 3 r o n �/ FLOOD HAZARD
PERMIT FEE $ BI£LAN CHECK FEN $ 2.,� / CERTIFIED BLDG ELEVATION
TOTAL FEE $77/1, SCHOOL IMPACT FEE $ SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT /K}- /KY f] PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY ie - 3
TYPE OF CONSTRUCTION 9/"., A./ ADDITIONAL INFORMATION NEEDED ".
S.F. OF BUILDING 4.2_7_4 S.F. OF LOT 5
MAX. HEIGHT .,),2., ROAD CLASS. ..-- CERTIFIED BY COLORADO REGISTERED LAND SURVEY0A
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED / ��/J
,JiJL a ,r Cs -les4�� 'i' /�.e. ? -30
APPROVED ■ !- _ .... .,/ 6 ,� 0 U APPROVED yam: "r' L
4100 ILDING DE'ARTMEN` or D E PLANNING DEPARTMENT DATE