HomeMy WebLinkAbout3251 er. ...� GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER
please print or type DATE
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS C.0 a n -1/2 2d a 2 NOTE: Show easements, property line dimensions,
a SUBDIVISION ■ all other structures, specify north, and street
6 FILING # LOT # BLOCK 11 name. For odd shaped lots, or if space .is
w TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TWV /RNG) # OF BUILDINGS NOW ON PARCEL
NAME _ PAn Y i it • . , p„ USE OF BUILDINGS NOW ON PARCEL _ —
MAILING ADDRESS cs'g5 Men., ,'n e 60 , 4.
p CITY ['0.P 6 dhgi.C(t_. PHONE 46 3 3 92-Z- - a NAME O W n N 1 " '
E ADDRESS CITY
a NAME pmt %r-
0
Q ADDRESS
0 PHOY /J P40/5 J
PHONE LICENSE # Q /
CLASS OF WORK
NEW ✓ ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model
S.F. OF BUILDING .F, OF LOT T. 53 aue...
# OF FLOORS k HEIGHT 7 q •
# OF FAMILY UNITS I _# OF BEDROOMS if
INTENDED USE OF BUILDING re.S1 @.K C -e
GARAGE: SINGLELi DBL SINGLE DBL
— — FRONT PROPERTY LINE
FIREPLACE 10 bkrnin9 54ve5
DOCUMENTS .,V •CIED STREET NAME /ROAD NUMBER
WATER SUPPLY nia/�'j.'/�': CHECK IF CORNER LOT _
DRIVEWAY PERMIT of ,,. DESCRIPTION OF WORK PLANNED
SITE PLAN /9P ' "
BUILDING PLANS
SANITARY SEWER CLEARANCE 1 , 4 1 0/ R SAS �� I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PE MIT application and the above is correct and I
OTHER DOCU NTS (specify) agree to comply with all county ordinances
x/ .., 'ii - :id P r/ - and state laws regulating building construction
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FOR OFFICE E ONLY ..
VALUATION J'y".Z 5- ,rt ° r FLOOD HAZARD
PERMIT FEE $ .5P� 'N C CK FEE $ 4 / 4, � � CERTIFIED BLDG ELEVATION
TOTAL FEE $ ,>%/ A :c C / MPA FEE $ e » - SPECIAL CONDITIONS
DATE PERMIT H UED ZONING DISTRICT PROBLEMS WITH PERMIT " TYPE OF OCCUPANCY
TYPE OF CONST:. , r,;- - - , ADDITIONAL INFORMATION NEEDED
S.F. OF BUILD 0 1,.?/ '' S.F. OF LOT at
MAX. HEIGHT _ CLASS. , / _ CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM "OPERTY LINE: FRONT j n ( OR ENGINEER
REAR / p t-f' RIGHT jai-,4 LEFT ...:(e)/ L C 6 /trio l u f'NY 79-^ /6l
OFF STREET PARKIN SPACE REQUIP,F,'y
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APPROVED: /Grp .SP��.. / , . r, e? CI e .4.
APPROVED; . /./(,` /hI'1 d--.� z'� /n
BU tr r DEPA DAT PLANNING DEPARTMENT DATE