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Home My WebLink AboutApplication - VOIDRECEIVED FEB04 GARFIE COMM Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970194s-82t2 www.ga rfi el d-countv.com County BUILDING PERMIT APPLICATION t Com mercial/Multi-Family Demolition Manufactured Home (Sinele or Multi-Level) Residential (SF, Duplex or Townhome)Reroof Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET PropertyOwner: Union Telephone Company Address: P.O. Box 160 Mountain View, WY 82939 Email Address: ?€t rredond o@u n ionwireless.com Mailing Phone:(307 )747-4827 contractor: Justin Haws. c/o Union Telephone Phone: ( 3O7 1747-7054 unionwirel comha Mailing Address: Email Address: o ()Architect: Mailing Address: Email Address: Phone: ( 307 1747-4900\-/ Email Address:mfisher@u n ionwireless. com Mailing Address: Engineer: Describe Work: lnstall an 8'(w)x10'(llx8 5'(h) electronics hrrilcling for the rrse of a telecommunications site alonq with a 6'fence around a 100'x100'site area Job Address: SESW of Section 15 Township 5S Range 97W Assessor's Parcel Number: 213715300009 fi)/ Phone: Sub Height: Owne/s Valuation of Work: 5 H,6oo.€ Sq. Ft. of Building: Email Address: Property Size (Sq. Ft. or Acres): # of Floors: I Manufactured Home lnstaller: Mailing Address: Lot Block 8'6" XClass of Work:New Remodel/Alteration Addition Garage:tt /AAttached Detached PROJECT DETAITS CONTINUED Septic:f,WTS x /*Community Type of Heat atural Gas Propane Electric Other Driveway Permit:l ExemPt N /s Permit # NOTICE Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove, 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, 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 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 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 designer, engineer and/ or builder. I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have provided the UI which correct and accurate to the best of my knowledge l-,\i"lrl,1-'i, Pro and Date tbo.4b ckf7b+zog oz/ztSOFFICIAT USE ONLY z6 Special Conditions:V Adjusted Valuation:Plan Check Fee Permit Fee:Manu. Home Fee: r-I/a Misc. Fees: Total Fees:Fees Paid: + tL6.+L Balance Due:BP No: B-to -a361 OWTS Nor rt /a Setbacks OCC Group:Const. Type:LZoning: ? BUILDING / PLANNING DIVISION : Signed Approval Date \) "rlor' t*'r@'OUeSS |t€^rt fou.lra- 1OtLlt+vt w<-.lCfIOrr/ A ITE SUILD,,N6 DEPARTMENr 708 Eighth Street, Suite 401" Glenwood Sryings, CO 87601 Tel: (97o) 945-82X,2 ?*.frff ao, r,p f,g cl\ A$PLAN REVI E\[/ CHECKLIST (A4*<.vt .rte- ?sfi,4 ,l/v&wre,,ca' Per6it No: Garfield County Building lssues Planning/Zoning lssues Engineered Foundation -P . Driveway Permit . O Surveyed Site Plan ?? Septic Permit and Setbacks , - O Property Line Setbacks ? 5sa*trl tl€fr gHo.r+J' e 30ft.StreamSetbacks -oa, 9fi8 '?'1a ' .. Flood Plain /Building Height Zonlng Sign-Off ?, . - Road lmpact Fees 1 O 6rade/ ropography +oy" ffo#e0 r' -NA Planning lssues Subdivision Plat Description & Summarv: ?.t ?,o ? IJA Grade/ Topogra phy 30% ;,y,-,.ffi Attach Residential Plan Review List Itc 5..et?,\t\enr Subdivision Plat Notes Fltr 6.r/vr\cwa*e ) Fire Department Review ,/. at Valuation Determination/ Fees Red Line Plans/ Stamps/ Sticker Attach Conditions Application Signed 40# Snowload Letter - Manu. Homes Soils Report Plan Reviewer to Sign Application / Parcel/ Schedule No. .NNc lt t){ f44/'P t/? ,/ NOTE: lf any required information is missing, delays in 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 until the 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 owner or by a person having written authority from the owner to act as their representative. I hereby acknowledge I have read, understand, and will abide with the requirements of this checklist. l-.5i- z a?'L Pro Dated