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åtS 8th $treet, Suite 40å
Glenwsod $pnir:gs, Ct 81601
{s70i 94s-8212
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[J Commercial/Multi-Family
il Vianufacturecl Horne {Single or Multi-t-evet)
ffl nesiclential (5F, tluplexorTownhome)
[-]l nccessory Dwelling unir (ADU) - MAX¡MuM sg¿Ë e]F 1,t]&$ sqLrARÊ Ffr€'Ë'
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INVÛE"V€ß PAR?!F5
tlreFlerfV ûwner: $tever¡ 8. ûaroi Udvarhelyi pr¡one: í2] S I 8CI5-S347
Mailing Âd¡lress: ltS W üiamond A Ranch Road, Carl¡ondale üfi S1629
Ë n, a i I Âd d res s : Ê!ËY-?L1d Y_9
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cÕnrräcsor: Bella ViÉla BuiÍders, Ële p¡ron*' 13Ü3 683-4663
hflaiting Address: .f 't. ilox 875 C::nifer ç* 8Cì433
Ëmaít,Addre¡sr ril$seli. burtrn@b*llavillabuilders. net
Arch¡te*: Red Pencil,Architecture
,-. . phônê: (3Û3 l 3S8-ô4{iû
Mailing Ad¿jr.ess: 726r\ Taulcity llrive, Langmont tü ßû504
Ðmail Âddress:mãrty@redpenciisrchitectu re,cc.'m
ËnsÉneer: Pq $ite Hngineering Pho¡re' {SÏt }227-6368
Mailin6 Acídrrass:
'!ËS5 timarrün trive, $uite âü2, Lafayette t0 8üCI26
Ëmail Ëqridress:daniel@ossGngr.com
Ma*ufsctured Ho¡me !¡¡staller: lliä flhone: {_,..-_
fø'laiËing J{ddress:
Ërnaïl Âddrcss:
PRÕJË T DËTÂITs
Þescribe Wc¡rk:
m¡q¡c\ef*a
jÐb Addfess: i tü w llia A. Ranch Road, tarbond
,4ssess$ds parcet M¡smher. 2393?ü3ü{:ü1 r
uup. AsSren {ìlen, FL{ì-'l
üwner's 1/êlr6åf¡sn sf lñi*¡rfu: t 'l Ûü,ll*ü
i*e F-1'L ._ Ëtô*k:lrng t
2íi,fi7 i .liı siFrt'rperty $i:e {$q. Ft. or Âcres}:
srã. Fr.of üuitdins: lêbÔ _r4eism: åqglltl?llf * ur nrnn',i-owelllainll,lpper
elass of Work:lrvv Âddition
¡it: i rr¡ti
,{
þ.'€arage:
l-*l
AemoA el/,itlteration
Detaçhed
PRÕJECT Ðf;TAlI.S Cf.}NTINUf; I)
Sêptic:
Type of &leat:
\'v l:;
ffi Natural Gas
[ffigì1"""'i.'t
Cómmunity
Electric
P€rmít *{:
i "Iott e'
ffi
firoparìe
Èríueway
Permit:
NÕTICE
&utlqrj$. Thís application for a Building pernlit mrisl be signed by the Owner of the property, described above,
or an autlrorized agent. lf the signature Lrelovu is not thât of the Owner, a separãte letter of authorìtv, signed by
the Crvner, must be provideci with thìs Application.
lggd-Aç-æll A Euilding Perrnit cannol be issuc-:d withouL proof of legal and adequate access to the property for
puiposes of inspections try the Buildiog D¡v¡sion.
*ther Ëerrnitå Mrrltiple sepârate pefm¡rs may be requlred: {:l} State lllcctrical Pernrit, i2) County OWTS Per¡nit,
(3) another pc'rmìt required for use on fhe property identifietl above, e.g. State or Cóunty Highwây/ Road Accass
or a State Wastewater D¡sr:hãrge Permii.
\lo-¡d Ferrnit. A Building Perrnit becornes nr¡il and void ìf the work authorized is not r;ommenceri wìthin 180 rlays
of the datri of issuarrre and il work is suspendecl or al¡anrJoned for a period of 150 days after commencemeni.
tIqì]'tF¡{A'r¡ûN
f hereby certifv that I har¡e read this Application and th¡i the infornretiçr¡ contained above Ìs true and correct. I
uncier-ctand that the tsuilcling Division accepts the Applicaiion, ålong wìtlì tlre plans and specifications änd oiher
data sub¡nitteci by me or on nry lrehalf (submittais], basecl tipon rny ceriifÍcation as to accuracy. Assuming
conrpleleness of the submittals and ap¡:rovai of this Application, a Buildirrg Permit will be ¡ssue.l grântìng
permission tû n1e, as Owner, to c.Jnstruct tlìe structurc{s} and facìlities deiailed on the subr¡ittals reviewcd by
the Buildíng D¡vision. ln consicleral¡on of tl-re issuancc o{'thc lìuilding Perm¡t, I agrêe th¿t I and nry agenis wil!
comply with provision-s of any fÞderal, state or lacal lav'; regulaiing ihe wolk and the Ger-field Couniy Building
Codê, OWTS reguiations and applicable lanrj use ieguiations (County Reguiationis)). I acknowlcdge ì:hâi th€
Building Êermit may be suspended or revoked, upon nor.ice fro¡ï the ii)unty. if the location. construci¡orl oi use
of the structut'e(s) and lacility(ies), cJascribcrì abovc, are not in cÕmp¡¡ãnce \,vith County Regulation(s) or" any
other applicable law,
I hereby grant permission to the Building Divis¡on to enter the propeny. described above, to inspecl thr: wo|k. I
further acknowledge that thê issuênce of tlre Building Permit claes nût prcvent the Building Official frorn: {1}
rec¡uir'ing the cor¡-er:tion of errors in i:he submit*rals, if any, disr:overec{ after ìssuance; or {2} stopping
ccrnslruction or use of The structul'c{s} or facilitv(ies) if such is in violation of County Reguiation(s) or any other
applicable lau¡. Review ûf thìs Âpptir:ation, including subrr¡ttãls, and ¡nspections of the wcrk by the Building
Divisian dc not constituTe ôn acceptance oi'responsibiìity ûr liability hy the County of errors, omìssions or
discrepancies, As the Owner, I ackrrowlerige that i-esponsibility fcrr cornpliance with federal. state and local laws
and CoUntV Regu¡ãtions rest r¡,iith nte anrl my ðul"horized âgerlts, ¡ncf uding withÐut linìitatiûn my architr:ct
clesigner, engineer and/ or builder.
I fìereby ãtkntw{ed8e thàt I hãve rÊñd ãnd underst;åüd thê f\tÕt¡cr: ðnd CÊrtiticaÈíûn above, as well as, have
provided the required inforrnatior¡ w is correct and ancurate ta the bÊst af nry knn',våeiJge.
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Pruperty äTrvrìer Frin{anri Sigr'l
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Speciêl C¿rnditiû¡1s:
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ßalance
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Const. Tv¡re:
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/O-BUILÞrfU6 / Pr.ÅrUNtñrS nÍVrsrûN
Signed Åpproval
ftg:
Date
-4 7
Gørfield County
BUILDING DEPARTMENT
108 E¡qhth Street, Su¡te 407, Glenwood Spr¡ngs, cO 81607
Tel: (970) 945-8212
P N REV IEWC HECKL IST
Building lssues
Perrnit No:ttf?tr-/Ì-zz4ø50
FlanninglZcnin lssues
?2
F-tz
e46e
æÆPln
eered Foundation
riveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ TopograPhY 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
d lmpact Fee
Grade/ Topography 40%
Planning lssues
Subdivision Plat
rte,uúaø/tdøru
>50aá Ktr
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Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No
40# Snowload Letter - Manu' Homes
Soils Report
Ðese nË Eon & Su¡mnn
/8Ao e.f, x 7e #b8! óz u/.þ
Attach Conditions
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