HomeMy WebLinkAbout4033GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER 1 c
please ptinU or type DATE fjii 19e )
TO BE FILLER OU BY APPLICANT PLOT PLAN
ADDRESS 7/0/ (.b 7 f iy,ys- NOTE:. Show easements, property line dimensions,
SUBDIVISION all other structures, specify north, and street
FILING #LOT #BLOCK #name. For odd shaped lots, or if space iS
a
TAX SCHEDULE #too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG)OF BUILDINGS NOW ON PARCEL, 4 /dn7,rm,rf
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USE OF BUILDINGS NOW ON PARCEL
El rrD11RF.5 lacer
MAILING
o CITY PHONE
a NAMEgaADDRESS 4 r CITY/
a NAME 2. ! II?r..,
u ADDRESS l"!7'F` ,,/r Ry pel ri'r a G Y rrd 0
A CITY r S 2
c°: PHONE n LI %NSE #
CLASS OF WORK
NEW ALTERATION J<ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING S.F. OF LOT
OF FLOORS aR HEIGHT
OF FAMILY UNITS OF BEINTENDEDUSEOFBUILDING5F /L7'lseKr+P
GARAGE: SINGLE_ DEL CARPORT: SINGLE DEL
FRONT PROPERTY LINE
FIREPLACE
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER d/ (114(47,7
WATER SUPPLY CX /A'T /A/&
W
CHECK IF CORNER LOT _
DRIVEWAY PERMIT _if DESCRIPTION OF WORK PLANNED q(sk
SITE PLAN Abel 4c_.
BUILDING PLANS p s-
SANITARY SEWER CLEA AN r401-I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT c ;f /JC7 *application and the above is correct and I
OTHER DOCUMENTS (specify)agree to comply with all county ordinances
annnd_ j a laws J. ting b.illddin• cons uction
SIGNATURE
r Jr87heeinJiastii OR OFFICE USE ,ONLY
VALUATION cg * P^ 3 yr. o FLOOD HAZARD
PERMIT FEE $. ? P [,'PLAN CHECK FEE $ a C2.. 9 7 CERTIFIED BLDG ELEVATION
TOTAL FEE 0¢ Z,, /,SCHOOL IMPACT FEE $ Al 4-SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT A1/40 ( 7 .6 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY A j
TYPE OF CONSTRUCTIO VI.- A/ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDIJg f C S.F. OF LOT
MAX. HEIGHT ROAD CLASS. ft CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT 4 „,, Alr OR ENGINEER
REAR RIGHT LEF
OFF STREET PARKING SPACES REQUIRED
APPROVED •I 41 " i ii .U APPROVED : ..altlY 7 /? .2e)
BUILDING DEPARTME T r•TE P 4 NING DE•ARk'EN”DATE