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Community Development Department
1OB 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www.ga rf ield-cou nty.com
Gurfield County
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
n Commercial/Multi-Family Demolition
! Manufactured Home (Single or Multi-Level)
I Residential (SF, DuplexorTownhome)Reroof
INVOTVED PARTIES
Louise Marron & Timothy Hasselmann Phone: P70 )
443-2015
Property Owner:
Mailing Address;PO Box 157, Carbondale, CO 81623
Email Address:lamarron42 1 @hotmail,com
contractor: Mathew Daugherty ptrone, (970 ) 309-7181
Mailing Address:420 Mesa Dr, Rifle, CO 81650
Emait Addresr. m.dconsulting@hotmail.com
Architect: Jack Palomino Phone: (970 )
379-9239
Mailing Address: 919 Palmer Ave, Glenwood Springs, CO 81601
Email Address:jackpalomino5S@gmail.com
Weeks & Associates 970 225-2422
Engineer:Phone:
Mailing Address:4730 South College Ave, Fort Collins, CO 80525
Email Address:evan@weeksinc.com
Manufactured Home lnstaller:Phone:
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:New build, residential home on 35+ acre lot
Single level home with a loft. Unfinished basemenUconditioned crawlspace for future development
Job Address:pending assignment
Assessor'sparcetNumber Zl Bt l9lO Olap
Sub.Mountain Springs Ranch totT Block _
Owner's Valuation of Work: S 400,000 Property Size (Sq, Ft. or Acres):35 acres
Sq. Ft. of Building:1183 fìn¡shed, 950 unf¡nished Height 17 ft g,1¡¡r.rr.1 +loft
Class of Work:I tttew l_JAlteration E Rddition ! nepair | | Move/Relocation
Garage:!Rttached ll Detached
PROJECÍ DETAIIS CONTINUED
I CommunityOWTSSeptic:
! Propane Electric l_lotnerType of Heat:I I Natural Gas
I lPermit #:Driveway Permit:Exempt
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal 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 Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Permit.
Void 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.
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Misc Fees:RwÆD þt.¿/', Plan y3
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BP No:
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OWTS No:
sEPl -1{39
Fees Paid:
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Balance Due:- -þ/,aî,*J'ìi'.âäb,nr
Const Type:tQl,t Zoning:ßv:,euSefbacks: ,AL OCC Groupl
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Signed Approval Date
Ut)6"2 ¡"#*W,
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
completeness of the submittals and approval of this Application, a Building Permit will be issued granting
permission to me, as Owner, to constructthe 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 provisions 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, 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 applicable 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 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 with me and my authorized agents, including without limitation my architect
desi nd/ or builder
edge that I have read a nderstand the Notice and Certification above, as well as, haveI hereby
provided ation wh and accurate to the best of my knowledge.
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