HomeMy WebLinkAbout3796 . J; GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERMIT NUMBER 417
please print Or type DATE ���� /0 /2 4 7
TO BE PILLED OUT BY APPLI'iiT PLOT PLAN
ADDRESS 1 r a s ,I NOTE: Show easements, property line dimensions,
SUBDIVISION - all other structures, specify north, and street
FILING # LOT # BLOCK # name. For odd shaped lots, or if space is
a TAX SCHEDULE # too small, provide separate plot plan.
LEGAL.(SEC /TWN /RNG) # OF BUILDINGS NOW ON PARCEL 'N it_
USE OF I•Dj T £- NOp7 pN PARCEL
cC NAME • r 1 � b ��//JJ°° bile- ( L 7 [v_ v.4
8 W MAILING AD i
CITY i PHONE,
i 5 � NAME
G ADDRESS CITY
s ec
NAME C
..._._��t' o y ~ �,
C. ADDRESS CITY C 4LJ / D/L 40
8 PHONE wZ5ICOLICENSE #
CLASS OF WORK
NEW X ALTERATION ADDITION
DEMOLISH _ REPAIR MOVE
MOBILE HOME (make/model) /�.
S.F. OF BUILDING / 40 S.F. OF LOT 4 /041.0.
# OF FLOORS HEIGHT
# OF FAMILY UNITS 60 # OF BEDRQOMS Z.
INTENDED USE OF BUILDING r
GARAGE: SINGLE DBL CARPOR : SINGLB DE
FRONT PROPERTY LINE
FIREPLACE
DOCU I TS ATTACHED STREET NAME /ROAD NUMBER
WATER SUPPLY
S , CHECK IF CORNER LOT _
DRIVEWAY PERMIT fe' -. DESCRIPTION OF WORK PLANNED
SITE PLA j r 1....„.....-- BUILDING P N
SANITARY SEWER CLEARANCE al - I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT
.7. affilffMr • 40lication and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state I regula • building construction
SIGNATU
FOR OFFICE USE ONLY
VALUATION ,_ vKf I -* " 00 i ) .) FLOOD HAZARD
PERMIT FEE $4i- 3'erPLAN CHECK Ft $4 . ?,42 CERTIFIED BLDG ELEVAT 0
TOTAL FEE $ ,Q'4 S CHOOL IMPACT FEE $ NA SPECIAL COND TIONS r ,,,. I,,.1,j r �lg i ' j , F
DATE PERMIT ISSUED 49'1,70 4 d'/ -/ _ .. , a/l��A IIL.GtLL7_
ZONING DISTRICT 14r /1,71? � PROBLEMS WITH 'ERMIT
l OF OCCUPANCY 1? ,,
TYPE CONSTRUCTION 11 ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING ; c 3 S.F. OF LOT are.-
MAX. HEIGHT M -- ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT • ,Ar..31 OR ENGINEER
REAR RIGHT L FT or
OFF STREET PARKING SPACES REQUIRED Q Q
APPROVED: / , .-. 1 4 1 , • ,t 1 r 7 APPROVED, 9.�/ #7
APPROVED:
DING EPARTME T DAT PLANNING DEPARTMENT / ATE