HomeMy WebLinkAbout3965 GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT e G /f
PERMIT NUMBER
7 6s
please prin or t pe DATE ( f l
2 ,/9 1 Q
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS 0331 Buck Point Road NOTE: Show easements, property line dimensions,
SUBDIVISION Panorama Ranches all other structures, specify north, and street
v FILING # LOT # 1 BLOCK # name. For odd shaped lots, or if space is
a TAX SCHEDULE # 011086 too small, provide separate plot plan.
LEGAL (SEC /TW.N /RNG) # OF BUILDINGS NOW ON PARCEL One
USE OF BUILDINGS NOW ON PARCEL residence
NAME.Iack 0. and Doris A. O'Neill
g MAILING ADDRESS 0331 Buck Point Rd
CITYCarbondale PHONEE63-OPR1
w
ADDRESS 1 4015 Lk o_W
fRCITY Janksn Y
NAME Numbey 9
ADDRESS Owner is contractor See separate sheet
CITY
— rc4^ °HONE LICENSE #
CLASS OF WORK
NEW X ALTERATION ADDITION
DEMOLISH REPAIR MOVE
. MOBILE HOME (make /model)
S.F. OF BUILDING 720 S.F. OF LOT 5,3 Ar.reg
# OF FLOORS 2 HEIGHT 24'
# OF FAMILY UNITS # OF BEDROOMS
INTENDED USE OF BUILDING
GARAGE: SINGLE DBL X CARPORT: SINGLE DBL FRONT PROPERTY LINE
N :FIREPLACE
_ DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER 0331 Buck Point Rd
WATER SUPPLY CHECK IF CORNER LOT _
DRIVEWAY PERMIT DESCRIPTION OF WORK PLANNED add free
SITE PLAN X standing garage
BUILDING PLANS X
SANITARY SEWER CLEARANCE I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT application and the above is correct and I
OTHER DOCUMENTS (specify) agree to a ••.ly with all county ordinances
and state s regulat'. g buiading construction
,r 1
r SIGNATURE
/32v (Q44.4 � %o.2A6C FOR OFFICE USE ONLY
VALUATION n 2_02 , 017 FLOOD HAZARD
PERMIT FEE $/'44o PLAN CHECK "FEE $6,719-1) CERTIFIED BLDG ELEVATION
TOTAL FEE $ /7Z.,4¢o SCHOOL IMPACT FEE $ L. SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY /l/(
TYPE OF CONSTRUCTION V — ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING /2 7_0 S.F. OF LOT
MAX. HEIGHT _ ROAD CLASS. t CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT - �, OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
i
APPROVED. h, / ,�
WILDING DEPAR N PATE PLANNING DEPAR PEST DATE
_. _.