Loading...
HomeMy WebLinkAboutApplicationGtt z field County 108 8th Street, Suite 401, Glemvood Springs, CO 81601 Ph:970-945-8212 Fx:970-384-3440 inspection Line:888-868-5306 www.gariield-couniv.com BUILDING PERMIT APPLICATiON M23 Injection Well Pump Building 1 Parcel No: (tins information is available of the assessors once 97O-945-9I3d) 19I7-274-00-012 Lot No: Block No: Subd./ Exemption: -- 1 AI : .: ,.... 2 Job Address: (Van address has nal been assigned, please pmride CR. HWY ortimer Nume & Coy) or and Icgal description SE,NW I/4 of Section 26, T4S, R96W 3 Owner: (property owner) Encana Oil & Gas (USA) Inc Mailing Address: 2717 CR 215 Suite 100 Parachute CO 81635 Ph: 970-285-2656 Alt Ph; 4 Contractor: Power Service, Inc. Mailing Address: 5625 Chapman P1 Casper, WY 82604 Ph: 800-743-4774 Alt Ph; 5 Manufactured home installer: Mailing Address: Ph: Lic #: 6 Architect: Mailing Address: Ph: Alt Ph: 7 Engineer: Brcndan Bummer- Power Service, Inc Mailing Address: 5625 Chapman P1 Casper, WY 82604_ Ph: 800-743-4774 Alt Ph; 8 Sq. Ft. of Building: 1020 Sq. Ft. or Acres of Lot: 15,800 acres Height: 10' 9" No. of Floors; 1 9 Use of Building: ❑Residential ®Commercial ❑Other Class of Work: ❑New ❑Alteration ❑Addition ❑Repair ❑Demo ❑Move 10 Describe Work: Construction & Installation of pre -fab skid mounted building to house an injection pump 11 Garage: N/A ❑Attached ❑Detached Septic: NIA ❑ISDS ❑Community Type of heat: N/A ❑Nat. Gas DPropane ❑Electric ❑Other 12 1 Driveway Permit: N/A Owners valuation of Work: 8200,000.00 NOTICE Authority. This application for a Building Permit must be signed by the Owner of thc property, described above, or an authorized agent. lithe signature below is not that of the Owner, o srparatc letter of authority, signed by the Owner, must be provided with this Application. J.eeal AreesY, A Building Permit cannot be issued without proof of Icgal and adequate access to the property for purposes of inspections by the Budding Department. Other Permits, Multiple separate permits may be required (1) Slate Electrical Permit, (2) County ISDS Permit, (3) another permit required for use on the properly identified above, e.g. Slate or County Highway: Road Access or a State Wastewater Discharge Permit. Vold Permit, A Building Permit becomes null and void lithe work authorized is not commenced within 180 days of the dale of issuance and if work is suspended or abandoned for a period of 180 days idler commencement. CERTIFICATION hereby certify that 1 have read this Application and that the information contained above is true and correct. 1 understand that the Building Department accepts thc Application. along with the plans and specifications and other data submitted by me or on my behalf (submittals), based upon my certification as to accuracy Assuming completeness of the submittals and approval of this Application, a Building Permit will be Issued granting permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the Building Department. In consideration of the issuance of the Building Permit 1 agree that 1 and my agents will comply wills provisions of any federal. state or local law regulating the work and the Garfield County Building Code, ISDS regulations and applicable land use regulations (County Regulation(s)) I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s) and facility(ics), described above, arc not in compliance with County Regulation(s) or any other applicable law I hereby grant permission to die Building Department to enter the property, described above, to inspect the walk I further acknowledge that the issuance of thc Building Permit does not prevent the Building Official from. (1) rcqumng the correction of errors in the submittals, if any. discovered eller issuance: or (2) slopping construction or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law. Review of this Application, including submittals, and inspections oldie work by the Building Department do not constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner. I acknowledge That responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer, engineer and/ or builder. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ AND UNDERSTAND T}IE NOTICE & CERTIFICATION ABOVE M -,� ZWI�� March 13, 2012 OWNS SIGNATURE DATE ?cQ ; .le-# 79a 11/Db1' STAFF USE ONLY Special Conditions: Adjusted Valuation: x,150 , m Plan Check Fee: 1 17 -1 Permit Fee: 181.7.5' Manu home Fee: 1400. °- Misc Fees: ..„--- Total Fees: 699.0& Fees Paid: i ttloa`i, 9 - Balance Due: jh 1:› 3/o. g$ BP No & issue Date: ISDS No & Issued Date: 3i_cD=a39- Setbacks: F/c ,� plod, 5/00 OCC Group: Const Type: '6 Zoning: R B DEPT eselLoye .-a .0 41 %� P dr, . J.. . „0.0..204.4.A... e/Z APPROVAL J DATE AP ROVAL DATE NOTE: If any required information is missing, delays in issuing the permit are to be expected. If determined by the Building Official that additional information is necessary to review the application and/or plans for compliance, the application may be placed on hold until the required information is provided. Work may not proceed without the issuance of a permit. The building department will collect a Plan Review fee at time of application submittal. The Permit Fee, as well as any Septic or Road Impact fees will be collected when the permit is issued. The permit application must be signed by the owner or by a person having written authority from the owner to act as their representative. hereby acknowledge I have read, understand, and will abide with the requirements of this checklist. _L. March 13, 2012 Signature of Owner Date Garfield County Building & Planning 108 8th Street, Suite 401 Glenwood Springs, CO 81601 Phone: 970-945-8212 Fax: 970-384-3470 www.aarfield-countv.com ■111PhiI' ,IMIlr1i1?,h4R1itN+l1Iih11R 1011.1114 11111 ReceptLonl: 51B102 02120/2012 11:14:59 AN Joan Albarica 1 of 1 Roo FoolS0.00 Doo Foo:0.00 GARFIELD COUNTY CO LAND USE CHANGE PERMIT FOR WATER TANKS AND MATERIAL HANDLING ON A 15,800 -ACRE PARCEL OF LAND OWNED BY ENCANA OIL & GAS (USA), INC. LOCATED 16.7 MILES NORTH OF THE TOWN OF PARACHUTE IN SECTIONS 23 AND 26, TOWNSHIP 4 SOUTH, RANGE 96 WEST OF THE 6TH PM, GARFIELD COUNTY. PARCEL NO# 1917-274-00-012 In accordance with and pursuant to the provisions of the Garfield County Unified Land Use Resolution of 2008, as amended, and Resolution No. 2012- l2of the Board of County Commissioners of Garfield County, State of Colorado, hereby authorizes, by Land Use Change Permit, the following activity: PRODUCED WATER STORAGE 1N TANKS ON WELL PAD F26 AND MATERIAL HANDLING RELATED TO AN INJECTION WELL ON WELL PAD M23. The Land Use Change Permit is issued subject to the conditions set forth in the above-mentioned resolution, and shall be valid only during compliance with such conditions and other applicable provisions of the Garfield County Unified Land Use Resolution of 2008, as amended, Building Code, and other regulations of the Board of County Commissioners of Garfield County, Colorado. ATTEST: N7 9erk of the Board BOARD GARFIEL ISSIONERS, ,COLORADO Chairma i 70169 Building Plan Review Description of Work: Construction & Installation of pre -fab skid mounted building to house Bin #: Location Address: PARACHUTE, CO General Information rCase Manager: David Bartholomew Plan Case Number BLDG -3-12-7182 Parcel: 191727400012 Application Date: 03/W2012 Owner: EnCana Oil and Gas Applicant: EnCana Oil and Gas Applicant Phone: (970)285-2656 Email: jasoneckman@encs Building Engineered Foundation Driveway Permit Surveyed Site Plan Septic Permit and Setbacks GradelTopography 30% Attach Residential Plan Review List Minimum Application Questionnare Subdivision Plat Notes Fire Department Review Valuation Determination/Fees Red Line Plans/Stamps/Sticker Attach Conditions -Application Signed plan Reviewer To Sign Application Parcel/Schedule No. 40# Snowload Letter - Manu. Homes Soils Report PlanninglZoninq Property Line Setbacks 30ft Stream Setbacks Flood Plain Building height zoning Sign -off Road Impact Fees WOAIDRC Approval Grade/Topography 40% Planning Issues -Subdivision Plat General Comments: 1 ill /r / 9 SBD. CC Sf7/:G Aril11f* /g/ ZS /Pui ; /17.8/ "Pbtx/7-12eSOD Mile/A- 10©%941 /uNZ7 5/v. 88 Friday, March 30, 2012