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Proposed Water Supply: <br />(See Division 4 enclosed as Exhibit "D"1 <br />Proposed Sewage Disposal System <br />Sani-Serv or equiv. <br />Existing Solid-fuel Burner N/A ~ Proposed Solid-fuel Burner N/A ! <br />--- <br />! Thereby certify, subject to penalty of perjury, that the above is true and accurate to the best of my ! <br />j knowledge and that I understand all provisions of County and State codes applicable to the proposed <br />development, any and all conditions placed upon the proposed development by the Board of County j <br />Commissioners and all information requested by this document. I also understand that if I violate any <br />i applicable provisions of County and~or State codes, 1 may be required to remedy such violation(s) ! <br />!, through appropriate legal process imposed by the County, including moving or removing structures <br />and ceasing of construction and/or uses. <br />Pathfinder Development, Inc. !Applicant's Phone: <br />j 970-728-3403 <br />! I I <br />gy; Date: 7~ ~ ~ i Applicant's Fax: ! <br />!Scott Smith, resident ! 970-728-1316 ! <br />I Applicant's Email: <br />s_smith@telluridecolorado. ! <br />~ net ~ j <br />Name and signature of Applicant <br />j ~.~ <br />I <br />[x] Site Prep [) ~ Building Plan N/A <br />[x] Excavation/Utilities ' [ ] :Addition/Remodel N/A <br />[ ] :Septic N/A [ ] ;Access. Structure N/A <br />(] Foundation N/A ; [ J ;Other <br />2. PLANN/NG DEPARTMENT SHALL VER/FY COMPLIANCE WITH: <br />Application Completeness _ (If incomplete, return to applicant) <br />Zoning Affordable Housing <br />Area/Activity of State/Local Interest: <br />Should Building Permit Application be considered? Yes <br />Floodplain <br />