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r-- - -- <br />! Proposed Water Supply: ~ Proposed Sewage Disposal System i~ <br />~ N/A ' SaniServ or equiv. <br />I <br />I I <br />Existing Solid-fuel Burner N/A ~ Proposed Solid-fuel Burner NIA <br />I I hereby certify, subject 1o 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 <br />I Commissioners and all information requested by this document. I also understand thatrf I violate any I <br />' applicable provisions of County and/or State codes, I may be required to remedy such violation(s) j <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. I Applicant's Phone: <br />! 970-728-3403 <br />I ~ I <br />By: i~ ,r Date: D ~ ~ Applicants Fax: <br />Scott Smith, President ~ 970-728-1316 <br />i <br />Applicant's Email: <br />j I s_smith@tefturidecolorado. <br />~ i net <br />~_ <br />----- -- ----I------ ---- _ _ <br />Name and signature of Applicant <br />I <br />~ ! I <br />;_..___._------._ ----------------------.-----------.~.__.--------___~_... --_j <br />! I <br />~~_....__ _~....._._........_........_.__r__.._._~__.__-.____'___~_...__..._..... _.._. __. <br />[x] i Sfte Prep [ ] ;Building Plan N/A <br />~_.--- ~ _______ ____ __ __ I I _ _____ _______ __ <br />f ._ _..... ..... ._ .. ._.. ._...~.... ...__. .____..... .. ._... .... _. _.. . <br />i [x] .Excavation/Utilfties ! [ ] . Addition/Remodel N/A I <br />i <br />j--_ _~ r - <br />! [ ] !Septic N/A ~ [ ] I Access. Structure N/A <br />-- _-._.-.------...---r--~ --------- ---------I <br />(] i Foundation NIA [ ] i Other ~ <br />2. PLANNING DEPARTMENT SHALL VERIFY COMPLIANCE WITH: _ _I <br />Application Completeness _ (If incomplete, return to appl'~cant) ~ <br />Zoning rAffordable Housing + Floodplain <br />Area/Activity of State/Local Interest: --~ <br />' Should Building Permit Application be considered? ^_ Yes _ i No <br />C:\Documents and Settings\AdministratorUvfy Documents\dev.permit.form RR R.O.W..doc <br />