HomeMy WebLinkAboutApplicationGur.field County
n EC efgepunity Development Department
tOg 8th Street, Suite 401
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GARFTELD COUNTY le70l.e4.s-8212
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TYPE OF GRADING
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. INVOIVED PARTIES
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PROJECT NAME AND TOCATION
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Project
Describe work: N¿W S Àna( " lA ($icfun09-
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Job Address:tors l-Wdh- Val-lu" [Sr
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Assessor's parcet Number: 2 n "It o do îOS T
Sub.Lot Sf _Block
Earthwork (square feet):Earthwork (Cubic Yards):ftôó
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Att UTILITIES MUST BE TOCATED PRIOR TO ANY GRADING
NOTICE
Authoritv. This application for a Building Permii must be signeà by the Ownei of the f roperty, UesciiUeO aboue, ot
an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by the
Owner, must be provided with this Application.
Lesal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Perm¡ts. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identifíed above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Permit.
Vold Permit. A Building Permit becomes null and void if the work authorized 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.
CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true 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
j completeness of the submittals and approval of this Application, a Buíldíng Permit will be issued grantíng
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
: Building Division. ln consideration of the issuance of the Building Permit, I agree that I and my agents will comply
, with provísions of any federal, state or local law regulating the work and the Garfield County Building Code, OWTS
' regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit
may be suspended or revoked, upon notice from the County, ifthe location, construction or use ofthe structure(s)
and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law.
I hereby grant permission to the Building Divisíon to enter the property, described above, to inspect the work, I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official 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 applicable law.
Review of this Application, including submittals, and inspections of the work by the Building Division do not
constitute an acceptance of responsibility 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 w¡th me and my authorized agents, including without limitation my architect designer, engineer and/ or
builder.
I hereby ácknowledge that I have riad and understand the Notice and Cert¡Rcation above es welt as
have provided the requ¡red information which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign Date
OFF¡C¡AL USE ONLy p¡ rp. Sroo.ôo c¡¿tf G1t7 oz/t4 /zszz_ æ
speciarconditions: ær¿ih4 *l f/[tlwe r¡4k ?¿¿iqJ lotilåivy¡ wwåt wiÅtu 4t
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tg'r"¡¿ î{wÅttrl,\tßtg tn'g/<ttûi't *gq Ò iuþ.àin9,
Perm¡t Fee:f too. æ Mlsc Fees:Total Feesr
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Fees Paid:
$ loo.æ
Balance due:+ø Gradlng Permlt:
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lsgueDate:Zoning:
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Signed Approval
artaþnBUttDtNG / PLANN|NG D|V|STON :
Date