HomeMy WebLinkAboutApplication- PermitJob Address
Nature of Work
Use of Building
Owner
GARFIELD COUNTY
BUILDING, SANITATION and PLANNING DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81801
(303) 945-8212
7700 312 Fd. New Castle, CO
C 3511
Bldg. Permit
Martha
ContractorOwner
Amount of Permit: $ 63 50 Data: 8/8/58
Permit 38.50
Plan 25,00
White- Treas.
Canary -Office
PI nk - Applicant
Gold- Du plicate
E. Haring
Clerk
GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
please print or type
PERMIT NUMBER ,15-9F-•
DATE
TO BE FILLED OUT BY APPLICANT
PLOT PLAN
W
DDRESS 276,0 3/2. fl0 AJlxu/ GAttf2P
SUBDIVISION
FILING # LOT # BLOCK #
TAX SCHEDULE #
LEGAL (SEC/TWN/RNG)
NAME
MAILING ADDRESS.,
CITY4(tpf /*J]!Lp.lO.
PHONE
1
NAME
ADDRESS CITY
m NAME
g ADDRESS
CITY
PHONE
LICENSE #
CLASS OF WORK
''NEW ALTERATION ADDITION
D LISH REPAIR MOVE
IMOBILE HOME (makg/model)
S.F. OF BUILD5pC 4 '�jpQ &V5
S.F. OF LOT t'p •
# OF FLOORS,“' l HEIGHT
# OF FAMILY UNITS f # OF BEDROOMS
INTENDED USE OF BUILDING,'$/pa.)r L
GARAGE: SINGLE DBL CAR RT: SINGLE .DBL
FIREPLACE
DOCUMENTS ATTACHED
WATER SUPPLY �g',,e)?;,/ L iffi k
DRIVEWAY PEIRMIrT` :4614404i
�.
SITE PLAN
BUILDING PLANS
SANITARY SEWER CLEARANC
ON SITE SEWAGE DISPOSAL PERMIT �= A r,k-,t
OTHER DOCUMENTS (specify)
OTE: Show easements, property line dimensions,
all other structures, specify north, and Street
name. For odd shaped lots, or if space is
too small, provide separate plot plan.
# OF BUILDINGS NOW ON PARCEL
USE OF BUILDINGS NOW ON PARCEL
f
a
G'dfQ Fr D
FRONT PROPERTY LINE
STREET N ” E/ROAD NUMBER
CHECK IF CORNER LOT _
DESCRIPTION OF WORK PLANNED 109.40 17-14,41.1
mHAT
uLth1/n� n v AJC
hereby acknowledge that I have read is
application and the above is correct and I
agree to comply with all county ordinances
and state laws reguildin construction.
SIU TUURE
FOR OFFICE
VALUATION At p
PERMIT FEE $ PLAN?CHECK FEE $2 Coo
TOTAL FEE $ o SCHOOL IMPACT FEE $
DATE PERMIT ISSUED
ZONING DISTRICT
TYPE OF OCCUPANCY
TYPE OF CONSTRUCTION /Kod t' 0g-
S.F. OF BUILD(1 4Xsgoo S.F. OF LOT 4c,e tt_c
MAX. HEIGHT -/-� /)., A ROAD CLASS.
SETBACKS FROM PROPERTY LINE: FRONT
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED .0 --
USE ONLY
FLOOD HAZARD
CERTIFIED BLDG ELEVATION
SPECIAL CONDITIONS
PROBLEMS WITH PERMIT
ADDITIONAL INFORMATION NEEDED
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER
APPROVED:
PLANNING DEPARTMENT "DATE