HomeMy WebLinkAbout2912GARFIELD COUNTY r
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER
e' 4 :1 please print or type DATE w 4 7k/i-15
AI,BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 'sir! 6.: 4;',. 1..C?" 4:NOTE: Show easements, property line dimensions,
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SUBDIVISION "".' ,v, ; l'O) all other structures, specify north, and street
FILING # 1' LOT # 9 BLOCK #name. For odd shaped lots, or if space iscD
W • TAX SCHEDULE #too small, provide separate plotilan.LEGAL (SEC /TWN /RNG)OF BUILDINGS NOW ON PARCEL
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USE OF BUILDINGS NOW ON PARCEL, ", r p, 55
tW MAILING ADDRESS e.,61 "." 4 '',2,5
CITY 'U PHONE PI 9
x NAME
6 m ADDRESS - •, CITY
a NAME
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ti ADDRESS
2 CITY Z
o PHONE LICENSE #
CLASS OF WORK
NEW y' ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING g S.F. OF LOT j r 7 J'C;..
OF FLOORS HEIGHT 4060
OF FAMILY UNITS OF BEDROO S 3
INTENDED USE OF BUILDING 2_ Sjlffe_ri lc G-
GARAGE: SINGLE DBL SINGLECARPORT: SINGL DBL
FRONT PROPERTY LINE
FIREPLACE Vpe7,4 L(.44.W.l.
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER t k/(/ w:;444
WAR SUPPLY X /, ..77IJ 9 CHECK IF CORNER LOT
DRIVEWAY PERMIT it-',
7
DESCRIPTION OF WORK PLANNED
SITE PLAN 217 , G i.i,) j 14L7,4 C..p,,,,
BUILDING PLANS A7- -1,C alen-e--A,
SANITARY SEWER CLEARANCE 4 ,,,yam 1 hereby acknowledge that I have . read this
ON SITE SEWAGE DISPOSAL PERMIT ,0042,0;440i45 application and the above is correct and I
OTHER DOCUMENTS (specify)agree to comply with all county ordinances
and stafr laws regulating building construction.
1"' . 4 ' . SIB' ATURE
r' .. T.K r t., , . , '' ,/,--: '?.::, . ,,,_FOR OFFICE USE ONLY
VALUATION FLOOD HAZARD
PERMIT FEE $ it r . a„ LAN CHECK FEE $ 4J A}--CERTIFIED BLDG ELEVATION
TOTAL FEE 47 , SCHOOL IMPACT FEE $ Al/SPECIAL CONDITIONS -
DATE PERMIT ISSUED 2 c? r'/Ji
ZONING DISTRICT f ..<r' L 1 1 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY
TYPE OF CONSTRUCTION..I ADDITIONAL INFORMATION NEEDED
OF BUILDING
MAX. HEIGHT
e SLF1 LASS.
4.'"
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED: 115.-1 'f: '' d,'.t.f . 9•j ,3 L,APPROVED :
BUZ,DING PART7ENT /DATE PLANNING DEPARTMENT
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DATE ,