HomeMy WebLinkAboutApplication''; _ Gur.flf111 C011111 1
Community Development Department
108 P" Street, Suite 401
GI[•nwnr)d Springs, CO R1601
(97fi) 945-14212
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TYPE OF GRADING
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INVOLVED PARTIES
Property Gwner: D AnV R 1 6�} o (�� E 2 S Phone: (�i 0_j
Mailing Address l,1 1 �1 VC2_(3E_A16 V/4 y 6 LCA1W0,,6 S P/Z w6 s 60 0 1 %0
Email Address: 6,iv10Q 130(-Kc1�Cor"S!RV[7113v,Com
Contractor: 0 r_kegS Goti 57 -2ve7'1 ()'V Phone: (170) i 7- 3 Sa %
Mailing Address: q r1 q Tki ve-a 4ENlo w4 r 6(6tiwn,)n Trzt s C4 flIII
Email Address: J t Ca. on cv-W Cnvsl• vcT t
Architect:-JOCLOIA/ Fl_U NtTEGTVIlk J-NC Phone: alQ 1 61 g (0690
Mailing Address: 00 �3 0Y. 0 3 1 G 1,i AWpo o %%A/6 $ Co '5V (00
Email Address: 6P-A8)ok04AlMc, R1Tfci (0.6M44(. , C o M
Engineer: / ' �C v S f aVC7V L -Phone: (�U �. iIt.0 `77! �o
Mailing Address: PO O ox j ,�7 7 Q i -S A C1 CO ft (o 31 _
Email Address: S T C V'E kF mp'/KTA WTQwNCG. Co NI
PROJECT NAME AND LOCATION
Project Name:
Date of Completion:
Description of Work: TNS' A bL S L 2 `E' V0 62 L I I CAA fS 4 NQ I
I
t� C A VA � ^Q2. No roI)vr7g IN t? ✓ 1
^� SAOOCt IBgck �flo i
Job Address: d�iQ r �
won LE r o
AssessoesParcel Number: %3 R J (111 0603 111 _
Sub. ASPEN GC(5A/ �. Lot r1" 3 �� Block 7
Earthwork (square feet): 07 0 Earthwork (Cubic Yards): u
a00 SA DOLE O AC k
w31/dS
ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
NOTICE
Authority 'rus ;,pphlhttrnn fnr a gl,111r114. ppr., t „ct hr c N••r.l I•,,� the C,v,^Pr of the property described above, or
;rn ;,uthr,rlrr.rl;,f�rr,t if thr• r.tpr,ature hmrW �c rr,+ t�.at r,f I�r ,a separate IFt[er of authority, signed by the
r)wr,nr rrnl°t he- ofrlVidwi with, Ihl<. Aripltral'nr
Legal Access !• fsullrlinE Pr rm,t t ,r,nnt hr• c:,,ted w:±hnut pro',f of It gal Anil adequate a((Pss to the property for
ftl trf,r,e a., rt1 Iri r. ft('l lnlril t y IFtf• �.nlf1'rljl i.J�t/i:. ill n
Othef Permits. ipq <f.paratf- pernl�l may he required ( I ) State Flertrical Permit (2) County OWTS Permit,
;rrnr,lher pe'lrnrt ,entn.erl for uf.P on 1hP property identifiPri ahnvP, P g State or county Highway/ Road Access or
wi, kk/;r'rf•wNler 01,,( hArw,p f"erm,I
Vold Permit A Ru, rlloF f1f., rail hel wmea null and void if the work authorued Is not (ommenced within 180 days of
Thr dr,lf , 1 i, , u: „r :, ,,1 f word is aur,pPnded or abandoned for a period of 180 days after commencement
CERTIFICATION
I kc-eh� l efl,fy that I have read this Application, and that the Information contained above Is true and correct. I
undf—land 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 Dlvulon. In 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.
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 required in m ion w tch is correct and accurate to the best of my knowledge.
Nvlo 0 ckr. q,5 I0t)3 ald '!r
Property Owner Print and Sign " Date
OFFICIAL USE ONLYX d
Special Conditions: G�ptTt<'�SS
Q� "n "qZL--
Permit Fee: 0
Misc Fees:
Total Fees:
Fees Paid:
Balance due:
Grading Permit:
Issue Date:
Zoning:
-01
BUILDING / PLANNING DIVISION:
to.. L9 25
Signed ,oval
Date