HomeMy WebLinkAbout3549GARFIELD COUNTY
BUILDINCr, SANITATION and PLANNING DEPARTMENT
1098th Street Suite 903
Glenwood Springs,Colorado 818o1
(909) 945-8212
GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
please print or type
PERMIT NUMBER -'g
DATE eve em
TO BE FILLED OUT BY APPLICANT PLOT PLAN
--- ADDRESS
SUBDIVISION
FILING # LOT # BLOCK #
TAX SCHEDULE #
LEGAL (SEC/TWN/RNG) SE t 1 S
cd NAME $
W MAILING ADDRESS StgSQd� 1
.ro CITY Cj' 1L.T P ONE 876-,QFj2.
NAME
ADDRESS CITY
rc NAME Fr
DDRESS
CITY
v
PHONE LICENSE #
NEW j/___.... ALTERATION ADDITION
DEMOLISH REPAIR MOVE .
MOBILE HOME (make/model)��/.d'Y`pQ�7�A
S.F. OF BUILDING /34 S.F. OF LOT/Zpc�
# OF FLOORS / HEIGHT
# OF FAMILY UNITS /T. # OF BEDROOMS 3^
INTENDED USE OF BUILDING
GARAGE: SINGLE. DBL CARPORT: SINGLE_ DBL
'FIREPLACE __.. T�
WATER SUPPLYj']I�J(
DRIVEWAY PERMIT
SITE PLAN fXXCZrS
BUILDING PLANS /", 42!y
SANITARY SEWER CLEARANCE —
ON SITE SEWAGE DISPOSAL PERMIT
OTHER DOCUMENTS (specify)
NOTE: Show easements, property line dimensions,
all other structures, specify north, and street
name. For add shaped lots, or if space is
too small, provide separate plot lan.
# OF BUILDINGS NOW ON PARCEL he,TIL p
USE OF BUILDINC,S NOW ON PARCEL $-Ciee
,¢Azxc-ke5/
FRONT PROPERTY LINE
STREET NAME/ROAD, NUMBER. i
CHECK IF CORNER LOT
D5SCRIPTIO OFOR/�{ P (NED
�d F t 4
T ereby acknowledge that I have read this
application and the above is correct and I
agree to comply with all county ordinances
and state laws regulating bq-ildinq construction.
s
SlWATURZ
FOR OFFICE USE .ONLY
PERMIT FEE $ 19,00PLAN CHECK FEE $/�IA�
TOTAL FEE $ r p, o SCHOOL IMPACT FEE $
DATE PERMIT ISSUED
ZONING DISTRICT,
TYPE OF OCCUPANCY 4p-�
TYPE OF CONSTRUCTION ♦, ♦.
S.F. OF BUILDING }/3 S.F. OF LOT �_ /4 dLe
MAX. HEIGHT +n. L ♦ ROAD CLASS. '' ♦,
SETBACKS FROM PROPERTY LINE: FRONT
REAR RIGHT LE
OFF STREET PARKING SPACES REQUIRED
FLOOD HAZARD
CERTIFIED BLDG ELEVATION
rrvy+T
PROBLEMS WITH PERMIT
ADDITIONAL INFORMATION NEEDED
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER
G /; F/
PLANNING; DEPARTMENT DATE
Sf
or
u�- h� 2 - .CS