HomeMy WebLinkAbout4963 N r 04963
GARFIELD COUNTY
BUILDING, SANITATION and PLANNING DEPARTMENT
109 fah Street Sults 909
Glenwood. Springs, Colorado 91801
(303) 945 -8212
2512 County Road 226, Rifle
Job Address
Nature of Work _ Buildin„ Permit
Use of Building Replace Windows /Siding;
Owner Lee Moss
Cc 'tractor Owner
Amount of Permit: $
1fl°.Oil Date: November t5, 11yn1
Permit: 102.00
5. Archuleta
Clerk
White - Treas.
Canary - Office
Pink - Applicant
Gold - Duplicate
GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT ���
PERMIT NUMBER
please print or type DATE /Fig-9, J q
Assessor's Parcel #
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS C,"t,_ #704:9 ,22C NOTE: Show easements, property line dimension,
.a SUBDIVISION all other structures, specify north, and street
FILING N LOT /I BLOCK H name. For odd shaped lots, or if space is
W TAX SCHEDULE N too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) (d OF BUILDINGS NOW ON PARCEL
W NAME -e€ v /� 5 ' 5
USE OF BUILDINGS NOW ON PARCEL
t �
MAILING ADDRESS , 571_ PH 21-0
3 CITY A �'- _ ONES ?d ^ 2/37 2_ ," 0 ,, a
NAME y 0 /P v
a w ADDRESS CITY 2 a
a NAME e &lo C $
� — 3 3 ep 6'5cce ,"
a
u ADDRESS p �
F CITY _ �"
Z PHONE LICENSE / _-
CLASS OF WORK -setat ,C per, ft ere L / r ur- I e e PM y Cc
VEW ALTERATION _ ADDITION Q/trf/EIGr o ?4W -
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model) - wr.tr0a's 4 l ✓ a 2�eSS
S.F. OF BUILDING /t.5j s.F. OF LOT 33 /}cre 973//3 M oP�o "2
/1 OF FLOORS '7-_ _ HEIGHT w �r�Uw.�. ` f ? . iv r
l' OF FAMILY UNITS f # OF BEDROOMS @ M / 20 « 0.'10 • .. n, //W I
INTENDED USE OF BUILDING n w! /A o, �-'
GARAGE: SINGLE DBL CARPORT: SINGL DBL
_ _ FRONT PROPERTY LINE
FIREPLACE ,/7�+
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER Cry AZ, '2-9
WATER SUPPLY CHECK IF CORNER LOT /J
DRIVEWAY PERMIT DESCRIPTION OF WORK ?LANNED getWCi'G -E
SITE PLAN 5 O /i /t /L- LWInc6ws , /y'r
BUILDING PLANS 5/d /l, 0,---r a m
SANITARY SEWER CLEARANCE I hereb0 acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building constructi.o:
f �P vY�en -
SIGNATURE
FOR OFFICE USE ONLY
VALUATION ! 000.— FLOOD HAZARD
PERMIT FEE $ ,./,‘ , }` i�I�N- en7 FEE $ CERTIFIED BLDG ELEVATION
TOTAL FEE p/> //, 1 I��CDOOL IMPACT FEE $ SPECIAL CONDITIONS
DATE PERMIT - .
ZONING DISTRICT PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY 1Z
TYPE OF CONSTRUCTION 1.0:1 ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING _ S.F. OF LOT
MAX.. HEIGHT Ar OAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOF
SETBACKS FROM PROPER(7 FRONT OR ENGINEER
REAR RIGT LEFT
OFF STREET PARKING SPACES REQUIRE A ir
APPROVED: 21601 ....Wa APPROVED: et _
�LDIN, �LliriEN'I' DATE PLANNING DsPARTMENT D 'F