HomeMy WebLinkAbout4079 4 GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT 77
PERMIT NUMBER /
please print or type DATE d� (l
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS NOTE:. Show easements, property line dimensions,
SUBDIVISION No all other structures, specify north, and street
• FILING # LOT # BLOCK # name. For odd shaped lots, or if space is
w TAX SCHEDULE # too small, provide separate plot plan.
.a LEGAL (SECLTW sfkj .; i n / # OF BUILDINGS NOW ON PARCEL _1p.µ e..
_
fiction / l e w. • ...r # • 4*" p.m USE OF BUILDINGS NOW ON PARCEL
R ; NAME Ad j: A v
, MAILING ANDRESS 116'7 CO as ' ,1,5'/: ' $'.2
0 CITYG4a'Shi jprl�S PHONE 7 yS — at" ^
'
NAME
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ADDRESS CITY nl
• NAME ; . I l�7"LL "'i /C?5 9[.I�- - � ®/� f
ADDRESS • .7" f, an c.... -p t. 1 Y r..?..
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CITY pa rA aft. �4—s S rr .J yr T 11fl
8 ( PHONE 2 g %37 LICENSE # — Mg � ,
< CLASS OF WORK ♦ / /
NEW DEMOLISH ALTE I OR ADD( TION ?e -- 4 (� WAire .. "kit h175 ` 45 d / / eec
. MOBILE 11029E make /model It$ (y'yx��e. R71La)(,S(�.7a /' /
( ) � 4voac� s' % /�21�� f6d7�d.4c c/�Li/ad
S.F. OF BUILDING 4,J y6p S.F. OF LOT j76.4 & re.t
# OF FLOORS 5� _ HEIGHT /.2 r sr rz ?.
# OF FAMILY UNIT / # OF BEDROOMS 3 J
INTENDED U' 7p'7q�g�aO!F BUILDING Dwe/i,I�
GARAGE: 5IN[;L'E" DEL CARPpRT: T DEL
a ry TC/ a
FRONT PROPERTY LINE
FIREPLACE z ��..e �.✓ e. eQ B " 7y. a ra.e
DOCUMENTS ATTACKED STREET NAME /ROAD NUMBER Ca••, +fir 844 170
WATER SUPPLY 0. Cr¢c i • • r if • �, .. CHECK IF CORNER LOT
DRIVEWAY PERMIT a7 /ra XI DESCRIPTION OF WORK PLANNEDSnffi./ Sr Ai�+7q/
SITE PLAN sea //]7�yj`� �r
, . c ,P/...... ,P/...... Y ;Iron Zwalr Cemcnte- r an t ^ 0--0 1 reatC. 7 ° :lIb =.r A
BUILDING PLANS WAIL /Naw..fa.y- ...-til HO - WC H. 14 ///Ie
SANITARY SEWER CLEARANCE - / / I hereby acknowledge that 1 7iav /
4//i read this
ON SITE SEWAGE DISPOSAL PERMIT /7c «!c/ N ci application and the above is correct and 1
OTHER DOCUMENTS (specify) _ agree to comply with all county ordinances
and sttla y la ing uil ing rnnstiuction
SIGNATURE
FOR OFFICE USE ONLY
VALUATION FLOOD HAZARD
PERMIT FEE $30,00 PLAN CHECK FEE $ 4#- CERTIFIED BLDG ELEVATION
TOTAL FEE $ 3 O oo SCHOOL IMPACT FEE $ 1 SPECIAL CONDITIONS
DATE PERMIT ISSUED 16 y
ZONING DISTRICT iJ /e/E .d PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY ear TYPE OF CONSTRUCTION v _ C.c jj :T/r0 ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING - /s ra o S.F. 0 LOT C rfr, .
MAX. HEIGHT °'t/ 2. ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
APPROVED: y . ),. i n „Ks ...„_.,„a / r ' I� APPROVED: - .. .,.., ,, 4c.... to `ea
�BUILDI G DEPARTM T DATE PLANNING DEPAR NT DATE