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Communlty fÞvelopment Depanment
108 8ü'Street, Sulte ¡101
Glenwood Sprlngs, CO 81601
(9701945€212
wrinil.sarf, eld-counw.com
Garfield County
BUILDING PERMIT
APPLICATION
CommerciaUMultí-Family Demolitíon
t Manufactured Home (Sinele or Multi-Level)
Resídential (SF, Duplex or Townhome)Reroof
Accessory Dwelling UnÍt (ADU) - MÆ$MUM SlzE OF 1,000 SQUARE FEEI
IITIVOTVED PARTIE$
Property Crrìrner:Lisa Moretti and Mike Podmore phone:{970 }456-2769
Malllng Address: PO Box 353, New Castle, Colorado 81647
Emall Address:wi Idgeeselj m @ gmai l.c-om
Contractor:Kopper Creek Buildins LLC Phone:¡970 ¡249-1148
Malllng Address;f 8786 US-550, Montrose, CO 81403
Emall Address:cayttie @ koppercreek.com
Archltect:Northstar Systembuilt Phone:¡507 ¡644-6600
Malllng Address:203 lndustrial Drive, Redwood Falls, MN 56283
Emall Address:
Englneer:Studio M Engineers, LLC phone;(970 t366-8690
Malllng Address:1 1 1 East 3rd St. f¿O2 Rifle, CO 81505
Emall Address:studiom.engineer@ gmail.com
Manufactur€d Home lnstaller;Kopper Creek Building LLC p¡e¡s; 197O ¡249-1148
Malllng Address:18786 US-550, Montrose, CO 81403
Emall Address:cayttie @ koppe rcree k. oom
Descrlbe Work:Prepare site for setting and linal construction of 1800 sq. fr pre-manufactured home and
168 sq. fi attached garage. Project includes stem wall crawlspace foundation and leach field.
Job Address:æ47 Cß,335, New Castle, Colorado
Assessol's Parcel Number:218104307001
516. Rapids on the Colorado lot 1 Block _
Owne/s Valuatlon of Work:Property Slze {Sq. Ft, or Acresf:3.65 ages
Sq. Ft. of Bulldlng:f800 Helght;17',9118*ü of Floots; 1
Class of Work:I New RemodeUAlteratíon Addition
Garage:/Attached Detached
Heat:
Septlc:
Type of
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PROJECT DETAITS CONTINUED
Community
Electric
Permit #:
Other
Drlveway
Permit:
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Authorlw. Thís application for a Buildíng Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
lepal Access. A Building Permit cannot be íssued without proof of legal and adequate access to the property for
purposes of ínspections by the Buílding Dívision.
Other Permlts, Multiple separate permits may be required: {1) State Electr¡cal Permit, (2} County OWTS Permit,
(3) another permít reguíred for use on the property ídentified above, e.g. State or County Highway/ Road Access
or a State Wästewater Discharge Permit,
Void Permit. A Buildíng PermÍt becomes null and void if the work authorized ís not commenced within 180 days
of the date of íssuance and if work is suspended or abandoned for a period of 180 days after commencement.
I CERTIFICATION
I hereby certify that I have read this ApplicatÍon and that the informatíon contained above Ís true and correct. I
understand thät the Buílding Divisíon accepts the Application, along with the plans and specífications and other
data submitted by me or on my behalf (submittals), based upon my certificatíon as to accuracy. Assuming
completeness of the submíttals and approval of thís Application, a Building Permit will be issued granting
permíssion to me, as Owner, to construct the structure(s) and facilities detailed on the submíttals revíewed by
the Building Divisíon. ln consíderation of the Íssuance of the Buílding Permit, I agree that I and my agents will
comply with provisions of any federal, state or local law regulatíng the work and the Garfield County Buildíng
Code, OWTS regulations and applícable 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 facilíty(ies), described above, are not in compliance with County Regulation(s) or any
other applicable law.
I hereby grant permission to the Building Divísion to enter the property, descríbed above, to inspect the work. I
further acknowledge that the issuance of the Buildíng Permit does not prevent the Building Official from: (1)
requiríng the correction of errors Ín the submittals, if any, discovered after íssuance; or (2) stopping
construction or use of the structure{s) or facílity(íes} if such is in violation of County Regulatíon(s) or any other
applicable law. Review of this Applícatíon, including submittals, and inspections of the work by the Buílding
Dívision do not constitute an acceptance of responsibilíty 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 wíthout limitation my architect
deslgner, gngpegl q,!V_ oqbyltdg¡,
I hereby acknowledge that I have read and understand the Notlce and Certiflcation above, as well as, have
provided the requlred lnformatlon ¡s correct and accurate to the best of my knowledge,
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Property Owner Prlnt and Slgn Dete
oFFrc¡Ar usE oNrY PA|O loo.e'D cK
Speclal C¡ndltlons:sæ attaúd æ/VD/77O/VS
tv'75 Manu. Home Fee:
$r{OO.o "
1/Fees Pald:*40o.*Fe-No:
B LMF- TTtS
OCC Group:
r.R c.
Const. Type:
I,R.c,
Misc. Fees:,\l /A
OWTS Ño:
sE ?T-1116
ZoninE¡
ßu IZAL
(I,,l,t);tah ?-K-z'BUITDING / PTANNING DIVISION ;
Slgned Approval Date
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NOTE: lf any required information is missing, delays ín issuing the permit are to be expected. lf
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold untilthe required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owrìer or by person having written authority from the owrìer
to ac't as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds forvacating the premises- (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, underctand, and wlll ablde by the requiremente of thls
checklist.f,ra*LT
Property Owner Sign Date
Gurfield County
BUILD'NG DEPARTMENT
108 Eighth Street, Su¡te 401, Glenwood Spr¡ngs, CO 87607
Tel: (970) 945-8272
PLAN REVIEW C HECKLIST
Permit na: êLrOt -Ø-Z-7V5
Building Issues PlanninglZoning lssues püt441
L/ß Driveway Permit ô@22-D-t6
-- Surveyed Site Plan
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ptic Permit and SetbackS
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perty Line Setbacks
30 ft. Stream Setbacks
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determ ination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
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