HomeMy WebLinkAbout3323 _ GARFIELD COUNTY
:‘. APPLICATION FOR BUILDING PERMIT 11
PERMIT NUMBER ../.,a // 1 g
please print or type DATE ///i ,'�
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS /107 Krn r R s Ayes _ .._ NOTE: Show easements, property line dimensions,
a SUBDIVISION K(n6S Row' all other structures, specify north, and street
<1 • FILING # _ LOT # x 31 . BLACK # name. For odd shaped lots, er if space is
a TAX SCHEDULE # — too small, provide separate plot_ plan.
LEGAL (SEC /TWN /RNG) _ # OF BUILDINGS NOW ON PARCEL
• NAME .�e r 1 {0$ C'(CC-2 USE OF BUILDINGS NOW ON PARCEL smeter
w F R ...__ FAO ky DlUaLl.ir1
. MAILING ADDRESS or gut T
o c.T'ry ASPeti, Cc?._ • I4. « RHONE c'63- 3o(oS you have ke proposrot pW'is, and
NAMF•. S IS#pJ ?urf' Rz 3307 ..._.. ,/Ov Man -the 0r ,llsnat p1RHS cu ,44-k
a ADDRESS 40 Lila r I4-.LL Rd. CTTY f'5o.51E ( . I I-e plaVl-
NAME 5Afit N-- ,FiRDa6.6EP "lox STAN ruck
ADDRESS 00 to F LK F pjfe RA. VDLIfk 14iil PI,
Pa CITY gsSACr AASAL - r •127 C7
P.
PHONE 911-3249 LICENSE' # __- I /
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CLASS OF WORK -- - j �� - - -. appfOXrrnate
! )_ .-
NEW ALTERATION ADDITION x - " 1 1
DEMOLISH � REPAIR MOVE'
�_...�._....r - �� be, v !way
MOBILE HOME (make /model) _
S.P. OF BUILDING 110 S.F. OF LOT Z,Y ACRSS I \ �
# OF FLOORS 2_ HEIGHT 2 g + ('a +kedral
# OF FAMILY UNITS I # OF BEDROOMS 3 /t ,,I
INTENDED USE OF BUILDING r], 1161E rriMiL Daeltn SINGLE DB
FRONT PROPERTY L iVB y
GARAGE: SINGLE DEL X CARPOR 2 : _ T.l . ;
,.. ` •
FIREPLACE: I _BvC�f 5TpyC __, __ C be
DOCUMF _ STREET NAME /ROAD NUMBER ffin /('nfi Pow Ake (26T
M
WATER SUPPLY rte' ,e 47;631 CHECK IF CORNER LOT _ p-
DRIVEWAY PERMIT �1 DESCRIPTION OF WORK PLANNED mimeo DI-
SITE PLAN A/tomy fer er !..i 1 /h/9Sra' 1371 ooerl ovrR L'k's,ro6 nAr
BUILDING PLAN. 1 ROOF engliFE - de/61MAf (' fr rn !M'ered FOR 004P.SC
SANITARY SEWER CLEARANCE ,Jty,IS I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT - - application and the above is correct and 1
OTHER D /1ENTS (specify �, agree to comply with all county ordinances
•, , ,•• d I / • -,iii r . and state laws regulating building construction
j / F/o r � d / 1 S� . . a. / M s.z�1AT / G (S i / {' [ltv n ' /
a FOR OFFICE USE ONLY
VALUATION Fr7Trifr,t— FLOOD HAZARD
PERMIT FEE $ /6,11 LAN CHECK FEE $ CERTIFIED BLDG ELEVATION
TOTAL FEE $ DJ SCHOO IMPACT FEE $ /�/ /4 SPECIAL CONDITIONS
DATE. PERMIT RUED , /I ' di ,
ZONING DISTRICT ,., an 4 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY
TYPE OF CONSTRUCTION -, __ / ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING, 4 ./I)/ S.F. _ OF LOT F
,
MAX. HEIGHT - ROAD CLASS. V r CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PR PERTY LINE: FRONT � OR ENGINEER
_
REAR TRIGHT �. LEFT F ,
OFF STREET PARK NC SPACES REQUIRED
APPROVED: nrj /!,� `I APPROVED:
pulp rDEPAR /ENT DAT' PLANNING DEPARTMENT DATE