HomeMy WebLinkAbout4052 r GARFIELD COUNTY
r " APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER
please print or type DATE '9[)
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 2 j ,orip,4x_ Clash NOTE: Shaw easements, property line dimensions,
,.a SUBDIVISION Cfrp,g,tgyq. all other structures, specify north, and street
FILING # J LOT # 11 BLOCK , # t4 name. For odd shaped lots, or if space is
TAX SCHEDULE # too small., provide separate plot plan.
LEGAL (SEC /TWV /RNG) # BUILDINGS NOW ON PARCEL 0
w' NAME gr USE OF BUILDINGS NOW ON PARCEL N /¢
i MAILING ADDRESS
?; bra / r ear,-,-,
CITY sperm rAdv ' c - ,..t ,PHONE jS -- V -rp
NAME NA=-'/ Pic /rc ,a4,,..
1 ADDRESS CITY 44 r,
o NAME -K3/e[' ['i.fuuE.. .�.t J 4aa.Z,____—
8 ADDRESS lT �MLa
CITY
g rHONE 2Px'- ?331 LICENSE #
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CLASS OF WORK
NEW 1.....-- ALTERATION ADDITION I. DEMOLISH REPAIR MOVE } Xt'Q EL- 7 --m C n o r 1 1 . iR like
MOBILE HOME (make /model) "/A.,1-0.0_,_ PRa- Ciu,t,7' / W //11
S.F. OF BUILDING /[/ ‘4,-0ern t
S.F. OF LOT � cro Wt 0 1 2-174 -
# OF FLOORS / _ HEIGHT // ' S et d J/ citi Sd e p /cw��
# OF FAMILY UNITS / # OF BEDROOMS 3
INTENDED USE OF BUILDING S+.,6ce Fa.' -
GARAGE: SINGLE DBLicCARPORT: SINGLE DBL / FRONT PROPERTY LINE
FIREPLACE
DOCUMENTS ATTACKED — STREET NAME /ROAD NUMBER C CmC.t.e
WATER SUPPLY G1ciyr /.w1 c CHECK IF CORNER LOT
DRIVEWAY PERMIT AIEWunmr. DESCRIPTION OF WORK PLANNED NcW Aa rsnu c w._
SITE PLAN ,6-TrA-4.44 c-h As y,,,rt, PrAd -n F rrt , ,4-- A/ c....1 2— Cap,..
BUILDING PLANS . Mr s6, LE c t.- b .av:, .... -Ills wt.. a
SANITARY SEWER CLEARANCE I hereby acknowledge that I have rea. this
ON SITE SEWAGE DISPOSAL PERMIT application and the above is correct and I
OTHER DOCUMENTS (specify) agree to •e. '.a..m. -- county ordi•_g ces
and • _ ing bui.ifl . struction
i /.�r{-ao :fe . d 2ra e- SIGNATUR: �.. ��r
• e1P- r'Y17Zll ` X G r-Ci
. v/v i FOR OFFIC USE .ONLY
VALUATION � 6, ZO .O 0 FLOOD HAZARD
PERMIT FEE $,74 PLAN CHECK FEE y S .15'1 o o CERTIFIED BLDG ELEVATION
TOTAL FEE $ 5 g, Co SCHOOL IMPACT FEE $ AILS SPECIAL. CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT /E? L/ PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY /c
TYPE OF CONSTRUCTION 4.4C S Sr /14.6 ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING 26900 S.F. OF LOT (vnn n
MAX. HEIGHT 't_`3' ROAD CLASS. Ai CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED: ', J/ I '1 /„ _.1.. 2 Jo '.1 APPROVED:'��� �`j �!/
17 NG , � .NP de DA0. PLANNING DE'ART NT DATE