HomeMy WebLinkAbout4059 GARFLELD COUNTY
APPLICATION. FOR BUILDING PERMIT
PERMIT NUMBER #2ry
please print or type DATE ?:/
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 0 3 0! M, a iC4v R d NOTE: Show easements, property line dimensions,
SUBDIVISION all other structures, specify north, and street
g 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 01
USE OF BUILDIN S NOW ON PARCEL
• MAILING ADDRESS pl 'Vfl' , r€QY •
g CITY Ai07„60,40 ge9,S PHONE jlylt 7,770 fai 9` - _ � X 4:I X 0 , .9 if
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ADDRESS CITY U Q ,e I/
m NAME . -L�J. (i�.� -tee /i e .)1 ! 4P "
E ADDRESS
CITY
PHONE LICENSE
CLASS OF WORK
NEW ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model) N
S.F. OF BUILDING 1 S.F. OF LOT
# OF FLOORS / -f- 4 kstwA) HEIGHT
# OF FAMILY UNITS 1 # OF BE ROOMS 3
INTENDED USE OF BUILDING ��_�.rCIP Arc i
GARAGE: SINGLE DBL CARPORT: SINGLE_ DBL
FIREPLACE _.__
DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER // 8��
WATER SUPPLY /C ( tT HED [ ., CHECK IF CORNER LOT _
DRIVEWAY PERMIT if DESCRIPTION OF WORK PLANNED
1 r
L.----- SITE PLAN /VA
BUILDING PLANS a - �% .. eo no 'we
SANITARY SEWER CLEARANCE 4/A- I herebyin ckn. ledge hat I have read t is
ON SITE SEWAGE DISPOSAL PERMIT _ ATf- application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and sty e laws regulating building construction
ST ,MATURE
FOR OFFICE USE ONLY
VALUATION O n,O. OD FLOOD HAZARD
PERMIT FEE $ 2 e, PLAN CHECK FEE $ 2-,C � o o CERTIFIED BLDG ELEVATION
TOTAL FEE $ 3,4.ca SCHOOL IMPACT FEE $ NM SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT / PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY - 3 ,
TYPE OF CONSTRUCTION V -- A./ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING 4i,q-- S.F. OF LOT
MAX. HEIGHT -+- (¢ ROAD CLASS. /V CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT,eta OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED - _
VED• - eir
�j /,..l! .1� s Z0 _.1. . . __ t .4/'I.
APPRO r4' _.1....i F3 t . '(� .
-BUILDING DE• "RTME , .A1" PLANNING.DEPARTM 'T DATE
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