HomeMy WebLinkAbout4144 GARFIELD COUNTY
.i' APPLICATION FOR BUILDING PERMIT I // 4 / PERMIT 1 :ER
please print or type DATE 4 , L saw
TO BE FILLED OUT BY APPLICANT PLOT PLAN
ADDRESS _ ye 32sR(C /4 / Rig/4/c 2 nice NOTE:. Show easements, property line dimensions,
SUBDIVISION all other structures, specify north, and street
FILING # LOT # .491- BLOCK # N4 name. For odd shaped lots, or if space is
TAX SCHEDULE # //A /J Q plot_
plan.
small, provide separate plot plan.
LEGAL (SEC /TW.N /RNG) /4 # OF BUILDINGS NOW ON PARCEL
- rx NAME MEWL • USE OF BUILDINGS NOW ON PAR
W MAILING D � �� R e s, d eM a s. / +/fl / LP €
0 CITY «iP/ P ONE 62-s -2 /OA
a
NAME DW/4er
ADDRESS CITY .
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x NAME i -VA, 1. , d -6 . c ;
G S ADDRESS C#. ' ._ 3 n
6 (PHONE 776 -29022 LICENSE #
U [
CLASS OF WORK ';� / 2cx_lf. C. '•2
NEW 1 ALTERATION ADDITION
DEMOLISH REPAIR MOVE
MOBILE HOME (make/model) / f
S.F. OF BUILDING 1/1/0 S.F. OF LOT 4 j �pi Pk S 0 4 1 �,; j
# OF FLOORS HEIGHT
# OF FAMILY UNITS # DBL CARPC T: O BEDROOMS ) .
W / SINGLE r ' 1
INTENDED USE OF BUILDING yp.P �ks1 Q1 _
GARAGE: SINGLE DB
FIREPLACE --- —
_— .....
DOCUMENTS ATTACHED _ STREET NAME /ROAD NUMBER
WATER SUPPLY E x,3)1 CHECK IF CORNER LOT _ f
DRIVEWAY PERMIT AA 9 DESCRIPTION OF WORK PLANNED /14( '
SITE PLAN ✓ r �Q /oyes, 40;43 for Ne %l,
BUILDING PLANS V I //
SANITARY SEWER CLEARANCE 4/4 I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT Ly/ application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building construction
SIGNATURE
``P1 f ( - FOR OFFICE USE ONLY
VALUATION (11.51.1_2-6 ¢ G 'P FLOOD HAZARD
PERMIT FEE $ S PN CHECK FEE $ z-Sx -.S3 CERTIFIED BLDG ELEVATION
TOTAL FEE $ 0 SCHOOL IMPACT FEE $ SPECIAL CONDITIONS r pc C' Cr ` 144,05 rtil.4,
DATE PERMIT ISSUED i L i
ZONING DISTRICT /1C /r9jt 0 PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY ix 3 _
TYPE OF CONSTRUCTION yr --A/ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING / S.F. OF LOT '-' `1'90p4c.,
MAX. HEIGHT �,..., i /¢, ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
/ 29 70 APPROVED: U- /. • c
ILDING DE•ARTMEhr ..ATE PLANNING DEPART N' DAT