HomeMy WebLinkAboutApplicationGarJield Cor,tnty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82t2
www.garfi eldcountvco.gov
TYPE OF GRADING
. tr MAJOR tr MINOR
INVOTVED PARTIES
propertyowner: Dobrowolski, Brian and Bernstein, Rosylnphone: (170 )181-1?ft
Mailing Address: 1901 Odin Drive, Silt, CO 81652
EmailAddress:Brian@mounta insideplu mbing.com
contractor: Premier Landworks Phone: 1
970 I 9230300
Mailing Address: Po Box 3593, Basalt, CO 81621
Emait Address: dustin@premierpm.net - put64 At eaGrA - p6f
Architect: NA Phone: (_)
Mailing Address
EmailAddress:
Engineer:NA Phone: (_)
Mailing Address
EmailAddress
PROJECT NAME AND TOCATION
Project Name: 1901 Odin Drive Grading Project
Date of Completion:
Description of Work:
Bt15t25
Cut hillside and level area for p arking. Build berms with excess dirt,
scrape and store topsoil for revegetation. Coco mat and hydromulch slopes, and berms
JobAddress. 1901 Odin Drive, Silt, CO 81652
Assessor/s Parcel Number
5ug. Asgard Sub. 3rd.
212726108006
tot 25 Block
Earthwork (square feet). 19000 sf Earthwork (Cubic Yards):3300 cubic yards
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
: NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, or
, an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by the
, Owner, must be provided with this Application.
.Legal Access. ABuildingPermitcannotbeissuedwithoutproof of legal andadequateaccesstothepropertyfor
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.
VoidPermit. ABuildingPermitbecomesnullandvoidiftheworkauthorizedisnotcommencedwithinl80daysof
the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFTCATION
, 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 thesubmittals and approval of thisApplication, a Building Permitwill 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)). 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 Official from: (1)
requlring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction
or use of thestructure(s) orfacility(ies) if such is in violatlon of County Regulation(s) orany otherapplicable 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, lacknowledgethatresponsibilityforcompliancewithfederal,stateandlocal lawsandCountyRegulations
' 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 required information which is correct and accurate to the best of my knowledge.
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Property Owner Print Sign Date
OFFICIAT USE ONt t
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'T2TT.oO *TUo.a'1:H6":oO Misc Fees:
Zoning:
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Balance due:H Grading Permit:qm:qhu lssue Date:-Tlnslas
?-23.25BUILDING / PLANNING DIVISION:
Date
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