HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.earfield-countv.com
TYPE OF GRADING
❑ MAJOR
1* MINOR
INVOLVED PARTIES
Property Owner: 1-rgvic ar / nn&Qr.&1 Tgic44-.y Phone: (970 )379-2 S0
Mailing Address: Cr/21 C'uu.n�-I (tock. A,I, C;11- RiLS1
.ICO
Contractor: h/vl ConAltA .k1 --0n Phone: (970 ) 3C.17 -.2O.2S
Mailing Address: ) l CjilhoLts e., Or. 'Z 1 C s#k, Co R1L914-7
Architect: Aeon C/A cc,co il/h E ip f cs b r Phone: (cf 70 ) 30 to - $L29
,
Mailing Address: G(eawO!.J
Engineer: / i s-1 Lap/ko rF, 1 -ti G...6.K.Irl 1-fii_ Phone: ( 970 ) RI5 -8L7 L., -
Mailing
Mailing Address:
PROJECT NAME AND LOCATION
Project Name: T1'"ictAi K-(S;Ore nG(,
rr i_
Describe Work: ExCA v c.i -c. circ �c c dZ Var a 111110 Sf 1'\DAS � cutin Q n
Gut c'.•., theca wo.lkoLA loasepot r1' 4 Li.; Ii-.
Job Address: Tin R.'clic co A LSO
Assessor's Parcel Number: 2I 2 7 32 4WO) ii.c
Sub. Lot Block
Earthwork (square feet): /31.20 Earthwork (Cubic Yards): 9-22
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
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Authority. This application fora Building Permit must be signed by the Owner of the property, described above, or
an authorized agent. 0 the signature below is not that of the Owner, a separate fetter of authority, signed by the
Owner, must be provided with this Application.
_Legal Accessi A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the propertyidentified above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permit.
Vold Permit, A Bulidirtg Permit becomes null and void If the work authorhed Is not commenced within 180 days of
the date of issuance and If work Is suspended or abandoned for a period of 180 days after commencement,
t hereby certify that 1 have read this Application and that the information contained above is true and correct, I
understand that the Building Division accepts the Application, along with the pians and specifications and other
data submitted by me oron 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 Division, In consideration of the issuance of the Building Permit, I agree that land my agents will comply
with provlslons of any federal, state or focal law regulating the work and the Garfield County Building Code, OWTS
regulations and applicable land use regulations (County Regulation(s)). !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 facllity(les), described above, are not in compliance with County Regulation(s) or any other applicable law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. 1
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1)
requiring the correction of errors In the submittals, If any, discovered after issuance; or (2) stopping construction
or use of the structure(s) or fadlity(1es) If such is In violation of County Regulations) or any other applicable law.
Review of this Application, Including submittals, and Inspections of the work by the Building Dlvision do not
constitute an acceptance of responsibility or liability by the County of errors, omissions or dlscrepandes. As the
Owner, 1 adumowiedge 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 I have read and understand the Notice and Certification above as well as
have provided the required information which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
forlfr
Data
BUILDING/PLANNING DIVISION. -- 6-1
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