HomeMy WebLinkAboutApplicationGø$wf.d C*anty
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RECEIVED
AU0 2 0 2018
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Êonnnrunlty Þevelop'-nenÊ EepartnrenÈ
lotr sesfieet, St tt€ ¡lo1
Glenwood Sprlngs' CO 816{11
i970) 94s-8212
Ma*ufactured Home
Residential ır
Demofftian
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Prgperty 9wner:
Maillng åddre¡s:
Emei! Address:
ANFY KWTOWSKI PI'æ:{408
ÃÃÃ ¡È6Etloo- tÐos
385 UfOODVIËW AVE SUITE Z5C Mff,RGAN HILL, CA 95C37
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fæasæ:UN¡r_lüRP lfì{e.Phone:.9711t-' -319-9853
775 FIRAVE. RIFLE, CO 8165ÛMailing Address:
Emall Address:mike. unieorp@gmail. com
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Enginccr: Fl¡æe:
ù,le¡fingAdd'ls; ,
Email Addressi ,. . ., --
ȡianufactured Home lnstaller: Phone: { }-
Eeseribc Ti¡'ork:Rcmov-e eurrËntw-osd shakes and underlãyment and repla-e
w¡th WP 3ûS and GAF Grand Canyon Stone Wood erÊhitec'tural shingles
Job AddresS 134 Riveæ GleR, Carþondale, ÇO 81ıã3
2393-191-S4-009
Villas Flg 5 tn- 9 Bb*-
Oxlnec'c Valuatlon of Worlc:¡35,5tt Propcrty Size {5q, Ft. or Acreef:-
l7 66
E r*,ñ+;i; f Ü uu¡elteiocat¡on
Sq. Ft.of Building:
Cfass sf rry;rlç
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€arage:Attached
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Septic:i f] Community
Type of Fieat:Natural 6as in
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Propane
Ðrlveway PerE¡rit:Exempt
Author¡ty. This applicationfor a Buildíng Permit
or an authorized ãgent. lf thè signature below is
must be signed by the Owner of the property, described above,
not that of lhe Owner, a separate letter of authority, signed by
¡LJe"t.it*,
the Owner, must be provided with this Application,
Lesal Accjqs. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purpos"r oi inspections by the Building üivision.
Other Perniqsr Multiple separate perrn¡ts may be required: (1) State Electrical Permit, {2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. Stâte or County Híghway/ Road Access
or a State Wastewåter Discharge Fermit.
Vgld_?ernJ3" A Euilding Permít becomes null and void if the work authsrized is not commenced within 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement'
c3NMFKÂTTOTI
I hereby certify that I have read this Application and that the information contained above is trt¡e 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 tne, â5 Owner, to construst the structure{s} and facilities detailed on the submittals reviewed by
the Building ûivision. ln consideration of the issuance of the Building Permit, I agree that I and my agents will
comply with provisions of any federal, stats gr local law regulating the work and the Garfield County &uilding
Code, OWTS regulations and applicable lend use regulations (County Regulation(s)). I acknowledge that the
Building Permit may be suspended or revoked, upon notice frsm the County, if the location, construction or use
of the structure(s) and facility{ies), described above, are not in compliance with County Regulation(s} or any
other applieable law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work, I
further acknowledge that the issuance of the Buílding Permit does not prevent the Euilding Offícial 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
applic*ble law. fieview of this Application, including submittals, and inspections of the work by the Building
Division do not conrt¡tute an acceptance of responsibiliry or liability by the County of errors, omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws
and County Regulations rest with me and my authorized âgents, including without limitation rny architect
I hereby acknowledge that I heve read and understand the Notice and Certification above, as well ar, have
provided the required information which i¡ corr€et and acct¡ate to the best of my knowledge"
020 t8
Property Owner Frint and 9igß Date
OFFICIALUSEOilIT
Speeial CondÌtions¡
Adjusted l/alüat¡on:Flan Check Feer Permit Fee:.'tloo.tÐ Manu horne Fee:Misc Fees;
Total Fees:Fees Pa¡d:
€f oa.oo
Ealanre Ouer+_BP:Ne-:OWT-S N8:
Setback¡:OCC 6roup:Const Type:Zonrns: 0øn
ôBU&Þ$ffG/ PLANNTNG DlVrStON :
Signed Date
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