HomeMy WebLinkAbout3614 GARFIELD COUNTY
c APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER
please print or type DATE
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS a./y. /13 NOTE: Show easements, property line dimensions,
SUBDIVISION O C V all other structures, specify north, and street
FILING # LOT # BL # name. For odd shaped lots, or if space is
w TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC/TWN/RNG) # OF BUILDINGS NOW ON PARCEL A / e
r:4 NAME .54... C , G , LE USE OF BUILDINGS NOW ON PARCEL
g MAILING ADDRESS ap3 6RA A AII.
5 CITY GLENG/OObSpt's5, PHONE S ys -503/ ply 1'07
NAME ;rSEPN ROI /LMI&Ek on-e
w ADDRESS VEAfrREE/U CITY mm cote,.
x NAME
0 ADDRESS _
° d CITY
(PHONE LICENSE #
CLASS OF WORK
NEW X ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make /model)
S.F. OF BUILDING S.F, OF LOT ¥7t a4/p,5
# OF FLOORS / 4-i #-1- q, HEIGHT /8
# OF FAMILY UNITS / # OF BEDROOMS 3
INTENDED USE OF BUILDING pets /Ln144/
GARAGE: SINGLE DEL CARPORT: SINGLE DBL FRONT PROPERTY LINE
FIREPLACE J/
DOCUMEN S ATTACHED STREET NAME /ROAD NUMBER 6 /113
WATER SUPPLY WelI CHECK IF CORNER LOT
DRIVEWAY PERMIT _ DESCRIPTJON OF WORK PLANNED /ono 74 C f"
SITE PLAN X # ei cP (f' ✓ ttr /u- - .1, P7 #70.a
BUILDING PLANS (re -r- e- r n7 %-&r.' b. en 4ot , A3ft . s .
SANITARY SEWER CLEARANCE I hereby acknowledge that I helve read this
ON SITE SEWAGE DISPOSAL PERMIT rolc_ittalej application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building construction
J -a.- ik
I
- cry t t A 4 d "/7 / SIGNATUR II
FOR OFFICE USE ONLY
VALUATION 6 • 0 IP FLOOD HAZARD
PERMIT FEE $ 6a lve PLAN CHECK FEE $440.60 CERTIFIED BLDG ELEVATION
TOTAL FEE $1,23,/0 SCHOOL IMPACT FEE $ A/4 SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT 4lje/ /) PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY 117�A
TYPE OF CONSTRUCTION
lit--. p! ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING /OAP S.F. OF LOT 4 tg c
MAX. HEIGHT 1 - 0 7- 1 .a€ ROAD CLASS. -∎ CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER _,
REAR RIGHT LE T r7CVi4 5 . ;` ILA/ -r1 ( 12 `1 ' rt 7
OFF STREET PARKING SPACES REQUIRED phi
e / //J/���/� r b fi.' .14 _- f.. �.�} i..741-11______ 1/l 0 1O e
APPROVED: '�� -l 10 4 �,/ L �+'� ioJ A'pP S/ 1
iILDING DEPARTMENT ( L AT PLANNING DEPARTMENT DATE