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No. 5396
GARI4ELD COUNTY
BUILDING, SANITATION and PLANNING DEPARTMEIVT
109 8th Strcct Suite 303
Glenwood Springs, Colorado 81601
(303) 94S-8212
07:83 County Road 264, Rifle
Nature of Work
Use of Building
Owner
Building Permit
Equipment Cover
Williams Field Services, Inc.
Contractor
Mt. West Fabrication, Plants & Stations, Inc.
Amount of Permit $
437.25
Permit: 265.00
Plan : 172.25
Paid $172.25 12-9-94
Date December 23, 1994
S. Archuleta
Clerk
Assessorts Parcel #
GARFIEi,D COUNTY
APPLICATION FOR BUILDING PERMIT
please print or type
PERMIT NUMBER
I 5-396
DATE /�/i / R+ Jc2 3 T9/
-
a
TO BE FILLED OUT BY APPLICANT
ADDRESS c783
SUBDIVISION A.//k)
FILING # LOT # BLOCK #
TAX SCHEDULE #
LEGAL (SEC/TWN/RNG) fQ /3 I v1, 6 s kty. �'♦NI
0
PLOT PLAN
NAME (,yl/(/cm.S t'rFc.
MAILING ADDRESS ,,g7c1 � , ' ,.2.4g14
CIT Y OX /e � GV PHONE _303 -62.5--3/E6
NAME ki; //;'4n -j �(r. (64 ,P.," LCS 'Sn c�
Z ADDRESS CITY` i,`f/ _
CONTRACTOR
NAME M Weft wir;t,ci o]n ,�l4nI,f s s1,,,- h5 s++t
ADDRESS //1.c /6 Ieoc d f
CITY /'414011 64:2
PHONEs1)3-$5V-1700 LICENSE ,'? n//L
CLASS OF WORK
NEW ALTERATION
ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make/model)
S.F. OF BUILDING 5-60. S.F. OF LOT
# OF FLOORS 1
HEIGHT /4'--O'"
# OF FAMILY UNITS Q # OF BEDROOMS tD
INTENDED USE OF BUILDING € y ip me+,f (�C
GARAGE: SINGLE DBL CARPORT: SINGLE DBL
FIREPLACE
DOCUMENTS ATTACIHED
WATER SUPPLY
DRIVEWAY PERMIT Fe15741
SITE PLAN mid) Fa /a u/
BUILDING PLANS yir/ 17) c# .
SANITARY SEWER CLEARANCE /Gfa� c..
ON SITE SEWAGE DISPOSAL PERMIT fie.Q,.te_
OTTER DOCUMENTS (specify)
''4Oc9Tro f c'F 'Xttrrr av/c o/ '
r4oP t /r?/t r9e.- '[ rtviy Trac
ch/#Ti C /N v s� n� i
Pio - (1 . (/
0
1 OFFICE USE ONLY
NOTE: 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 �y
USE OF BUILDINGS NOW ON PARCEL
707,e-ci 46L,44 -
FRONT PROPERTY LINE
STREET NAME/ROAD NUMBER 078.3 c,12_ a6 lL
CHECK IF CORNER LOT rDE5CRITION OF WORK PE
D
f4/icvti 4vv)
I hereby acknowledge that I have read this
application and the above is correct and I
agree to comp.Lq with all county ordinances
and ate l egulating building construction
l.�
SIGNATURE
VALUATION Gt U (2
PERMIT FEE a /f;! PLAN CHECK FEE $/ 7
TOTAL FEE $41:17....?' SCROOL IMPACT FEE $
DATE PERMIT ISSUED
ZONING DISTRICT
TYPE OF OCCUPANCY ,%- q
TYPE OF CONSTRUCTION•
S.F. OF BUILDING 3 -co S.F. OF LOT
MAX. HEIGHT /y ' ROAD CLASS.
SETBACKS FROM PROPERTY LINE: FRONT
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED:
FLOOD HAZARD
CERTIFIED BLDG ELEVATION
SPECIAL CONDITIONS
PROBLEMS WITH PERMIT
ADDITIONAL INFORMATION NEEDED
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER
.2•1 -9 APPROVED:
BU LDING DE RT 1 DATE
PLANNING
EPARTMENT
ATE