HomeMy WebLinkAbout3958 "a a GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER 39s7
plesse type DATEiQ
TO BE FILLED OUT BY APPLICANT �/ PLOT PLAN
/ //
ADDRESS I-p'T 3z. NOTE: Show easements, property line dimensions,
a SUBDIVISION K#U4 6 1 2 Ou all other structures, specify north, and street
cg3 FILING # L02-, # BLOCK # name. For odd shaped lots, or if space is
TAX SCHEDULE # _ too small, provide separate plot plan.
I-1 LEGAL (SEC /TWN /RNG) # OF BUILDINGS NOW ON PARCEL /1/'•l 4
NAME t/, CLE USE OF BUILDINGS NOW ON PARCEL
5 MAILING ADDRESS PC- &»C et?-6, pp 1
p CITY f l� V co R14) Z PHONE /63 - .iugr 3 a (c( L ^-3 Z 3 I - /'� ,- b v L S T 1 )
NAME ' tie Palle WHIT' U
ADDRESS 53J t$.&MCI-rr L. CITY F_ C et.
a s NAME p w fN(?e
ADDRESS
CITY
PHONE LICENSE #
/ CLASS OF WORK
NEW Y ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING /51$ S.F. OF LOT a.- gar cy c•
# OF FLOORS 7 HEIGHT
# OF FAMILY UNITS 1 # OF BEDROOMS Z.
INTENDED USE OF BUILDING (.2 &5Ice.Y E
GARAGE: SINGLE DBL CARPORT: SINGLE DBL FRONT PROPERTY LINE
FIREPLACE %/ '
DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER 14 ,1„ s Rmov b. L ,
WATER SUPPLY RIIxis eQuo eI SrelV\ CHECK IF CORNER LOT _ `
DRIVEWAY PERMIT DESCRIPTION TION OF WORK CANNED J/ -
SITE PLAN ✓ 4 �+ ' S 7 LP"'LC C... -S i cI P ,vn r' c
BUILDING PLANS V/
SANITARY SEWER CLEARANCE 1J( I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT INC: application and the above is correct and 1
OTHER DOCUMENTS (specify) agree to comply with aII county ordinances
and s e laws regulati • •uildi g construction.
1. 4 A Van*
SIGNATURE
gfFOR OFFICE USE ONLY
VALUATION Ca /30.00 FLOOD HAZARD
PERMIT FEE $2QJdo PLAN CHECK FEE $l7/,7S CERTIFIED BLDG ELEVATION
TOTAL FEE $47-8‘,7c SCHOOL IMPACT F E $ Am- SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT .��/e /AZ 0 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY ,4•.--S !
TYPE OF CONSTRUCTION V -Al _ ADDITIONAL INFORMATION NEEDED _
S.F. OF BUILDING / 570 S.F. OF LOT S, gr
MAX. HEIGHT 64_1 E ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT-ci OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED -
APPROVE' a . . /j„deaf 1 4l/ APPROVED: - .rte" : e . ai e• (/
= ILDING DEPARTMEN ' D TE PLANNING DEPAR ,v DATE ,,,,