HomeMy WebLinkAbout4051 GARFIELD COUNTY
. APPLICATION FOR BUILDING PERMIT f
Z
PERMIT NUMBER '1
) 3AK[ln.a.+7-- °a *, please print or type DATE %/10) I
TO BE FILLED OU BY APPLICANT PLOT PLAN
ADDRESS 2.. — NOTE:. Show easements, property line dimensions
▪ SUBDIVISION M..vti,..re°',c`T me le._ v.0 „be ali other structures, specify north, and street
4 FILING # LOT # Z.}g BLOCK # jsue name. For odd shaped lots, or if space is
▪ TAX SCHEDULE E # too small, provide separate plot plan.
LEGAL TWaV RNG re -
TwN/RNG) Sr SS # OF BUILDINGS NOW ON PARCEL C7
USE OP BUIL,_yGS NOW ON PARCEL ,c/ /y
y, NAME r{p47Lcj ,vs.tid• l eTw...ies aa
F MAILING ADDRESS 2 Bad 4 omm i y J p
PHONE � 1 °p•
CITY 7.481 °7are iiii4 .s date
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NAME _ X�// —' Ya n C T
m `' ITY 0tw 8 �
' a ADDRESS CITY t] /Uf
n NAME GC.rc/�/r �.r rYA ifn.va
e ADDRESS CA„An.E s
1 CITY 45 kN1
PHONE y.$�^ 3-$ 3 / LICENSE # .7\
L $
CLASS OF WORK r /
NEW ALTERATION ADDITION �
DEMOLISH REPAIR MOVE _� , `• t /
MOBILE HOME (make /model) y /1' Ci
S.F. OF BUILDING /z4Am S.F. OF LOT 47/4 `C et)/ # OF FLOORS / HEIGHT /�,
#' OF FAMILY UNITS / # OF BEDROOMS _
INTENDED USE OF BUILDING 1. w6 tAr A#..... .PC'T. / QN
GARAGE: SINGLE DSL��CARPORT: SINGLE DBL FRONT P ROPERTY LINE C]
FIREPLACE acts /.►rye.
DOCUMENTS ATTACHED — STREET NAME /ROAD NUMBER Sge",.. c
WATER SUPPLY ,4,,.a . A d A474 CHECK IF CORNER LOT
DRIVEWAY PERMIT tare, DESCRIPTION OF WORK PLANNED Areal S..cror
SITE PLAN elorrs4-t.4 -er - rger. . 9&-.5.
BUILDING PLANS A-rrez0-01]
SANITARY SEWER CLEARANCE d I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT AZ:e application and the above is correct and I
OTHER DOCUMENTS (specify) agree to compI t ' -'fl -aunty oain noes
and state --I ating bu .ing nstruction
SIGNATURE
• r
/z7 g" A /P. O } OFFICE USE ONLY
VALUATION «7
O-, 3\ S , o e. FLOOD HAZARD
PERMIT FEE $2,9 ?0 PLAN CHECK FEE $/ eg, ?$ CERTIFIED BLDG EL8'VATION _
TOTAL FEE $ .- SCHOOL IMPACT FEE $ 474• SPECIAL, CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT ..0> //.> PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY e- 3
TYPE OF CONSTRUCTION il AI ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING / 75:3 S.F. OF LOT
MAX. HEIGHT -1 -/ 4 ROAD CLASS. — CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
/� Fdz' al.
APPROVED: 2�,w�r ..2-g 0 APPROVED • / dr �
BUILDING DEPARTME 'T
if DA PLANNING DEPART NT DATE