HomeMy WebLinkAboutApplicationGurfteld County
GRADING PERMIT
APPLICATION
jR r_l il igpn!4unity Development Department
108 8th Street, Suite 401
JtjL l t ;igptpnwood springs, co 81601
Clr:\i..i-ii.;..i.,,., ., (970) 945-82L2
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TYPE OF GRADING
MAJOR MINOR
INVOLVED PARTIES
Property Owner:
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Mailing
Phone: (_)bLb/vlrf N VeTftVA SLvs:4Q-
68 L-f,{ L?
EmailAddress: YnAe
Address: tlGS llthLbx'tN cw&t
Contractor: ltp Cdr(tn&.rcTrc;rrJ
^'{Pelry,
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Phone: flY0 I m-+ltt
Mailing Address
Email Address:
Architect: ltl Uv{tQ't/Cttbf,' RJfeN, uL{/ll
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Phone: ( l'
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Mailing Address
EmailAddress:
EmaitAddress: Srev€(A nLtuNT Ad,vTifh/N 6" (An/\
Phone: fi+6 |103 -1tL6
?-l{A co
Engineer:Ol,lrlTA l[l "TCI^/N) cw tUti t
Mailing Address
PROJECT NAME AND LOCATION
AcLe'ri lil rtsr It
rob Address' lSt llvaoVW/
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Block
trl ffir?)Earthwork (square feet):
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Earthwork (Cubic Yards): 26h
Date of Completi on: lL,3t.?-oZs
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WrDbbl.l be€ F-
CnegDNtALE I u Yltt:t
pB.tv vwADescription of Work:
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Assessor's Parcel Number
brr
tuv{38 lxt
Project Name:
Feea. Bsau
Lot llsub. fuoaa EN De Un
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
I hereby acknowledge that I have read
have provided the required information
Frl,u'0 LptT,lM
Property Owner Print and Sign
the Notice and Certification above as well as
is correct and accurate to the best of my knowledge
2c{ s, o} ,lLl
Date
Authoritv. This application for a Building Permit must be signed bythe Owner of the property, described above, or
anauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedbythe
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.
ple separate permits may be required: (L) 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlB0daysof
the date of issuance and if work is suspended or abandoned for a period of L80 days after commencement.
Other Permits. Multi
CERTIFICATION
lherebycertifythatlhavereadthisApplication,andthattheinformationcontainedaboveistrueandcorrect. 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, Iagree 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)). All County development requiring a permit,
except for residential uses, are subject to Article 7 of the Land Use and Development Code. 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 Officialfrom: (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 responsibilityfor 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.
OFFICIAL USE ONtY t
special conditions: Ccrrrlpd_ p tlS{- 4+O Ll;l4p:$5 . Rer 6<*4,-r rt$) clt_\?€aE
TfprtE 6QoSt+> csprrfiu>. AAlrsr1lrrr IJL.L p[aA\prvG€ at-t {rE 6<t*c,trtR-tF(r \r atottSsrU-s PZo P<+t:Ilc5 orKta0:Ts+rc$ ?asvoa. L,sf,tq\rGr_
f,mtc rS pdT- tOc.-dFFD 'our-fS T€y2rr(o 6e fq?lgrxre'O {tcg
o"'ifiitp Misc Fees:'tb6''.oo 'TPf .oo
Balance due
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Gradine Permit:
Ar?..Lh, Q6+c(
lssue Date:Zoning:
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1-rB-?sBUILDING / PLANNING DIVISION
Signed Ap Date