HomeMy WebLinkAbout3409 ,ter" .. GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER S.D 9
please print or type DATE /� /g7
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS e ) 31� Z Natic.Fny7"La NOTE: Show easements, property line dimensions,
I-1 SUBDIVISION all other structures, specify north, and street
d FILING # LOT # BLOCK # name. For odd shaped lots, or if space 7.s
a TAX SCHEDULE # p :.2L3 09?. _ too small, provide separate plot plan.
LEGAL (SEC /TWN /RNG) 2,Z; 7 /y�
5. Cp # OF BUILDINGS NOW ON PARCEL /
NAME 4 4 F kiC.�/ USE OF BUILDINGS NOW •N PARCEL,� y �r 8
0 MAIL NG ADDRESS pxyc 3/3 p � '
CITY ,4d 1.4/( PHONE .- .z :.S?Zn(wstrMor #ha,est, /,ekt4
1 NAME
a ADDRESS CITY
m NAME e / Pa W�. t / /z. in JIGS
p, ADDRESS /� / K 1 '
1 CITY _ v4 o K., 4v .L 17/ - ^ CO ;I
DHONE LICENSE #
i
0...---- CLASS OF WORK es, g J v eht�.4 a•rs)
NEW j ALTERATION ADDITION /a Oi a C.° d
DEMOLISH REPAIR MOVE — _ e S G o w n e r• C,C
MOBILE HOME (make /model)) YT
S.F. OF BUILDING 9 l F. OF LOT 9C AL [.Ce"tSe /tce s • of /a'ck
# OF FLOORS 1 /� HEIGHT I r o f Ple4T Serrft e f.,,
# OF FAMILY UNITS / # OF BEDROOMS
INTENDED USE OF BUILDING ..6414 ff ('5,,,, yMgt 14 d ni e •
GARAGE: SINGLE SINGLE DBL CARPORT: SINGL DEL
_ FRONT PROPERTY NINE
FIREPLACE /rj/p 0jlp y
DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER 313 12,10
WATER SUPPLYf. /ep,l — CHECK IF CORNER LOT
DRIVEWAY PERMIT DESCRIPTION OF WORK PLANNED
SITE PLAN CoN5'ra 11CT N -ft 1 scienA a-
BUILDING PLANS J
SANITARY SEWER CLEARANCE te / hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT ,)7 pplication and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating ui ding construction.
....4,/ j
, e a. .
44/ v b. S. a 7 .4 1 - Z S- 'ofbo0 SIG TURF
'Pt FOR OFFICE USE ONLY
7
VALUATION s r-2-'1;0.00 / FLOOD HAZARD
PERMIT FEE $ �PairMakK FEE $ � CERTIFIED BLDG ELEVATION
TOTAL FEE $ $ L I SCHOOL IMPACT FEE $ A SPECIAL CONDITIONS
DATE PERMIT ISSUED */ ?S'
ZONING DISTRICT ,�1/L -4/1p PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY
TYPE OF CONSTRUCTION '0I ADDITIONAL INFORMATION NEEDED _
S.F. OF BUILDING /.3f ) S. F. OF LOT ...S9 pr-
MAX. HEIGHT -.4^2. e ROAD CLASS. .--r CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONTfl3: OR ENGINEER
REAR RIGHT LEFT C ,J,jN •3 lit Vselt ire iLleilt
OFF STREET PARKING SPACES REQUIRED i � GUCSf l'vn..i, re t.
..yr° Spe ,- -e vs"` Perm
APPROVED: .��/(_ / ,i/�LLfi� " ! D. Lnee„ if 26,1 eitP
O r ILDING DEPARTM.N' ' Di E PLANNING DEPARTMENT DATE