Laserfiche WebLink
IMPORTANT: In these spaces _, . the corresponding information from Section A, <br />BUWttZ STREET ADDRESS (kicki gApt, No}CRF.D ROUTE AND MU NO <br />STATE <br />SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION CONTINUED) <br />Copy both sides of Sys Devaxn Certificate for (1) dxcrtmurrty Adak (7) Man ages r any, and (3) buiding owrer. <br />COMMENTS <br />In Check here If ettaChments <br />SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) <br />For Zone AO and Zate A (vidhOUt AFE), Mete Hems 51 Itragh Si If the ElevaLrn Cerldoate t5 mlabed Ite itee suppotyng mfamah i for a LOMA of LOMR.V. <br />Section C "rust be mnpieted See Attachment AA) <br />Et kitting Dram Number _(Seed rite ttak rig d most Boiler 10 Cie building for which 7us coca a is Peng oarcieted — see pages 6 and 7 lf no ddagrarn aauratery <br />moment the bulldog, provide a sketch aphdogratt ) <br />E1 The top d the tam floor (including basement a enclosure) d the bulking Is _, d (ni)!n (cm) 0 above a ❑ below (check one) the highest adjacent grade (Use <br />mesa grade, d available) <br />E3 For Ong Diagrams S.9 veth opeangs (seepage 7), the need Vet floor or eteveled ccr (elevation b) of the building is _ ft(m) _In (cm) above the *al *scent <br />gr ade Carolete items C3 h and C3 on front d Tam <br />ECM: top d the platform of machinery ansit( ecuiprnent serviang the building _ 1t (m) n (an) ❑ above x ❑ below owe( me) the Hoe acia:ent grade. (Use <br />natual tom, If evalab(e) <br />ES For Zone AO ally' If no hood depth number Is available, is the top of the t:anan fixr elevated in awdasoe meth the community's looddain tnanagenrelt ordinance? <br />❑ Yes 0 No ❑ Unknown The acal OW must nerdy this Hama n n In Section G. <br />SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATNE) CERTIFICATION <br />The p owner ceowner's authorized representaNe v,ho completes %tons A, S. C (hams C3h and C3.i only), and E (a Zane A Macula FEMMs u mn rYty- <br />issuedSPE)orkneAO The statementsMSech 'atsAaGandEast fe thehestofrnylQawfedpe : <br />$ • A • . PRESEMATIVE'S ;� E w <br />kt J it I /,; <br />ADDRESS <br />3390 Drennan Industrial Loo. North <br />G4 PERMITNMER <br />G7 Ttrs permit has beets Issued for. ❑ New Consetxaon ❑ Substantial tmprwernerl <br />GS. Elm/acrid es -butt lowest tax (irtduding basement) of he buding is <br />t� BFE ce (ln Zme AO) depth dew ag at the budding site Is <br />LOCAL OFFICIAL'S NAME <br />COMMUNITY NAME <br />SIGNATURE <br />CONVENTS <br />PEM1A Form 81 -31, Ja Uiry 2QQn <br />ae/LE 39Vd <br />05 DATE PERMIT ISSUED <br />CITY <br />Colorado Sa rin <br />SECTION G - COMMUNITY INFORMATION (OPTIONAL) <br />The local official who Is authorized by taw a ordnance to adder the aommunys iloolian management advice can cormiste Seteons A 8, C (or E), and G d this FJevada+ <br />Certlicate Confetti the eppicabte kern(s) and sign below <br />G1. Q The irdom atim In Salon C was *en from d . h e r doalrnertatiat Mel has been signed and embossed by a ke+sed surveyor, engineer, a architect v4 o is authorized by stale <br />a loll law to ow* elevation inbmraban (Indicate theseurce and dale of the eleeson data into Comments Brae be(wv.) <br />02 ❑ A community dfipai completed Sect* E for a budding keeled in Zone A (vnthout a FEMMasued a oanrn itpissued BFE) or Zone AO <br />G3. ❑ The fobvwi fom but (Items G4G9) is pre raced faaxnrTuMty &p tekt marwgamentpu pm, <br />TITLE <br />DATE <br />G6 DATE CERTIFICATE CF OOMFL1aNCFACCUPANCr ISSUED <br />TELEPHONE <br />5TA7E <br />Colorado <br />For Insurance CamoriUse <br />Poky Netter <br />j C NNC Writer <br />❑ Check here if attachments <br />Datum <br />D aum <br />(Meek here if attachments <br />Replaces ill preview edldAm <br />ESa 912ZLV6E509 85 :T0 1200Z /TT /Z0 <br />