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~11r~brf ti <br />/ • MON III IIIIIIIIIIIII III ~ <br />DRI1/EWAY ___ . ERMIT <br />1 ~1 S. Townsend /~ Access Perrnlt rt 1~~ ~q,~/),~ 1/ <br />P.O. Box 1289 / , <br />fi c~ ~ /~J" BuiWing Permit # <br />Ctaontros9, CO 81402 d--~~~~ '`~ <br />Pnone: (970) 249-6688 ~ '~ ~ _= _ ~ S. r,;.oi <br />Fax: 970 249-6680 ~ ~ ~ P S~ ~ !)I ,. <br />( } kc~el~~d By: <br />3G~f85' 3~ a0 ~~-7~~ -- <br />~-,e ~c- <br />SITEADDRESS -±-r-r-~-s-r //// <br />:; ::Hers Name: F,4 _' ~ • ~~~ ~ +i > ~ n Phune No ~~d % 7~~/ (- _ <br />^.Iallir.gAddress:~~i ~n Y ~" ~:~ _--_. <br />~ p,. ,. <br />r P~//.tZ/'~ h~' ~~ .c~!,-_.__-- ,, ;irJare55 RcGurc7 rc5~f LC-- <br />l:on[ractor: <br />~ . .. <br />r ......- <br />i'rood Foremari/Criveway Inspector: r , ~~ tip % ~f// <br />Phone No <br />`Phone No _1'~ ~_ 7/n D.~' Oistricr <br />^RESIDENTIAL CMANUFACTURED HOME ~j(COMMERCIAL i INDUSTRIAL <br />PLOT PLAN <br />Show EXISTING propen~t lines, buildings, county roads, and driveways WITH DIMENSIONS <br />~.:~ <br />Ttje C un y a su es tha th I inf rm do p vi ed itlj this peFmiil is~ccyrat~ in all details. I' thG approved access <br />- <br />Irrlpac s a o er ro ert ov ine s g I is .e., ee I~t e~ el <br />ement, letc.~; tfile pQrmlt may 6e eKe~mine~ nu~~nd <br />l I <br />--- - - - - <br />----- - - --- <br />--- <br />---- -- --- <br />_ ~ <br />I <br />- <br />~ <br /> I ~ <br />I <br />I - <br />i ~ <br />--r--- -~ -----~-- - - - - - .. <br />T om- I ! <br />~ ~ t~=~~>i;~+,~E~- <br />- <br />I' <br />~ <br />{`~~ <br />I i t <br />-i--~~- I <br />~- ~- ~ <br />~ <br />~ <br />~ <br />~ 1~- 1-~-~'-~=-^-r-~~ ' "~ <br />rr- - K=' u~ -;-- <br /> I I <br /> it i <br />I i <br />(\x~\ I i <br /> <br />'~ 11 --Fr ~ ~ ~~~ ~ --= -- _ - -- -- --- ------ ' <br /> <br />I <br />, ~Er~-,.t--~-~-- <br />I i ' <br />':~ ~'L ~ <br />. .. . I I I r <br />. ~ <br />I <br />i <br />Applicant acknowletlges that this permit .s void if not~used within 12 months after application date. <br />APPLICANT'S SIGNATURE <br />Date ~ / <br />TO BE FILLED IN BY ROAD FOREMAN <br />Driveway Location <br />CMP Diameter- <br />Embedding klateria <br />~;de of Entrances <br />Exits Irom County Road S~, <br />. i .. 1 <br />~ -. /..f . <br />Plans and s~bcfications'given above are approved for <br />r <br />Installed system complies with approved plans and specifications. <br />/: <br />i <br />i <br />~rr. n,.~o, ,F,~~n nnNARV . i antl Usu ~ PINK , HoaU Fpriman <br />Ch1P Lengm <br />Embedding Depth ' <br />Roadypmn]an r Onveway Inspector D3ic <br />Road Foreman ~ Driveway Inspccmi Wig <br />GOLDENROD ~ H..a..y.~wymBpeW. L r) C,4TrJ ~ m. vom.. ~~. :c:,~ <br />