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Home My WebLink AboutApplication~ ..... --------------------..... ----m;;;j ~ Garfield County -] Community Development Department SEP 3 0 2016 108 8th Street, Suite 401 G Glenwood Springs, CO 81601 ?.t'(t 11:.l.. '-' v Mf/UNi iY DEVE:L (970) 945-8212 wwlN.garfield-countv.com 6 TYPE OF GRADING ~INOR ------------D MAJOR l INVOLVED PARTIES ~~operty Owne-r:--~---~-P~~-• • Mailing Address : f7 b . ~o/ "'3-51 3 Contractor: ..::r o s. Ii Pb l-\ . S I R t E. f £ '-Phone: ( 9'70 ) CJ '-I ~ -"3 d 'a G, Malling Address : p.o · B C¥-;o t...( '6 ~ ~ 1 ~ 5? I '2 d I Architect: N ~ H ~ Phone : ( 7~l>) ~ 11 -fo 3 O MaillngAddress: P o . G :>D ~A ~ , t.c,._ ~---~1 ~·-- Engineer: R /\ l< 0 ...,_,, S k I -M t L L. /"t R l> Phone: ( q 7 0) Cf '1 3 q "l.f M alling Address: ( ~--, S ~ f?..1) I~-'-{ ~ /o?, ~ ~ - PROJECT NAME AND LOCATION ProjectName: l11.-J ~ ~ Describe Work: .lL""f ~ ~ ~ A=f>: ""~ ~b) ~ ~ Assessor's Parcel Number: <J.. 3 Cf 3 "J. 9 4 0 d 0 ~ t:J ~........-,;::=-----~-----~~~-----~ Sub.~~ Lot d. ':a _Block __ -.....,....__,_ __ Earthwork (square feet): 'J. '::l L C... Earthwork (Cubic Yards): --~:........Lf.__..l..._ __ ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING NOTICE Authority. This applicat ion for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Applic ation. Legal Access. 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 property identified above, e .g . State or County Highway/ Road Access or a State Wastewater Discharge Permit. Vold Permit. A Building Permit becomes null and void If the work authorized is not commenced w i thin 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICATION I hereby certify that I 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 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 Division. In consideration of the issuance of the Building Permit, I agree that 1 and my agents will comply w i th provisions of any fede r al, state or local law regulating the work and the Garfield County Building Code, OWTS regulations and applicable land use regulations {County Regulation(s)). I acknowledge that the Build ing Permit may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s) and facility(ies), described above, are not i n compliance with County Regulation(s) or any other applicable law. I hereby grant permission to the Building Div ision to enter the property, described above, to inspect the work. I 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 facility(ies) if such is In violation of County Regulation(s) or any other applicable law. Review of this Application, including submittals, and inspections of the work by the Building Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner, 1 acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without limitati on 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 corr ect and accurate to the best of my knowledge. ~q :! OE. 5•Rt£FF-L.. ~(i~ °t i W // (,. Property Owner Print and Sign Date OFFICIAL USE ONLY Special Conditions : 6 ' P-/rOIU.C, <:p~ i /?r.<J/A:,tU, Permit Fee: c::J IOO. oa a:d Vasa 9-SO·t ~ d/t». oo Misc Fees: IS,I( Fees Paid : :/:>. 00 Zoning: ·2>·1lo PV 9·20 -z_Of:, Date