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Special Conditions:
<br />Fees Paid & Date:
<br />Permit Fee:
<br />Balance Due:
<br />Grading Permit:
<br />Issue Date:
<br />., uilding & Planning Dept:
<br />APPROVAL DATE
<br />I
<br />rarcei No: (thus information is available at the assessors office 970- 945 -9134) t7 f \ t 1 t LL) U U U N
<br />2409 - 144-00 -093 aulLoNG & PLANNING
<br />2
<br />Job Address: (if an address has not been assigned, please provide Cr, Hwy or Street Name & City) or and legal description
<br />Highway 6 &24, approx. 3/4 mile southwest of Parachute , a parcel of land in the SE1 /4 S 14, T 7 S, R 96 W, 6th PM
<br />3
<br />Lot No: NA Block No: NA Subd/ Exemption:
<br />NA
<br />4
<br />Owner: (property owner)
<br />Puckett Land Company
<br />Mailing Address 5460 South Quebec Street,Ph:
<br />Suite 250, Greenwood Village, CO 80111
<br />303 - 763 -1000
<br />Alt Ph;
<br />303 -521 -5688
<br />5
<br />Contractor:
<br />SEMA Construction, Inc.
<br />Mailing Address 7353 S. Eagle St.
<br />Centennial, CO 80112
<br />P 627 -2600
<br />Alt Ph:
<br />6
<br />Architect / Engineer:
<br />Mailing Address
<br />Ph:
<br />Alt Ph:
<br />7
<br />Sq. Ft. of Grading: 3 / ' i
<br />2 42
<br />Cu Yd. of Grading: / U , UU U / +✓ v 2 el cis
<br />8
<br />Describe Work: A borrow operation which will remove a portion of a hill leaving a flat area and an hill side
<br />for use as rangeland.
<br />9
<br />ALL UTILITIES MUST BE LOCATED PRIOR TO ANY GRADING
<br />Authority.
<br />This application for a Grading Permit must be signed by the
<br />letter of authority, signed by the Owner, must be provided
<br />A Grading Permit cannot be issued without proof of legal
<br />NOTICE
<br />Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate
<br />with this Application.
<br />and adequate access to tbe for
<br />PropatY purposes of inspections by the Building Department.
<br />Electrical Permit, (2) County ISDS Permit, (3) another permit required for use on the property identified above, e.g. State or
<br />Discharge Permit
<br />is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180
<br />CERTIFICATION
<br />contained above is true and correct I understand that the Building Department accepts the Application, along with the plans
<br />based upon my certification as to accuracy.
<br />a Permit will be issued granting permission to me, as Owner, to construct the structure(s) and facilities detailed on the
<br />will comply with provisions of any federal, state or local law regulating the work and the Garfield County Building Code,
<br />I acknowledge that the Permit may be suspended or revoked, upon notice from the County, if the location, construction or
<br />with County Regulation(s) or any other applicable law.
<br />described above, to inspect the work. I further acknowledge
<br />l or s that the issuance of the Permit does suc is in the io n of
<br />any, discovered after issuance; or (2) stopping construction or use of the structure(s) or lacrlity(ies) if such is m violation of
<br />work by the Building Department do not constitute an acceptance of responsibility or liability by the County of errors, omissions
<br />compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without
<br />THE NOTICE & CERTIFICATION ABOVE:
<br />3/a1// L
<br />laud Access.
<br />Other Permits. Multiple separate permits may be required: (1) State
<br />County Highway/ Road Access or a State Wastewater
<br />Void Permit. A Permit becomes null and void if the work authorized
<br />days after commencement.
<br />ereby certify that I have read this Application and that the information
<br />_ad specifications and other data submitted by me or on my behalf (submittals),
<br />Assuming completeness of the submittals and approval of this Application,
<br />submittals reviewed by the Building Department
<br />In consideration of the issuance ofthe g Permit, I agree that I and my agents
<br />ISDS regulations and applicable land use regulations (County Regulation(s)).
<br />use of the structure(s) and lacility(ies), described above, are not in compliance
<br />I hereby grant permission to the Building Department to enter the property,
<br />Official from: (1) requiring the correction of errors in the submittals, if
<br />County Regulation(s) or any other applicable law.
<br />Review of this Application, including submittals, and inspections of the
<br />or discrepancies. As the Owner, I acknowledge that responsibility for
<br />limitation my architect designer, engineer and/or builder
<br />I HEREBY ACKNOWLEDGE THAT I VE READ AND UNDERSTAND
<br />,� -
<br />O ` ' ' SIGNA DATE
<br />GARFIELD COUNTY GRADING PERMIT APPLICATION
<br />108 8 Street, Suite 401, Glenwood Springs, Co 81601
<br />Phone: 970 - 945 -8212 / Fax: 970 - 384 -3470 / Inspection Line: 888 - 868 -5306
<br />www.garfield-countv.com
<br />STAFF USE ONLY
<br />APR 17 2012
<br />['vd G eI , Lv i l t 13-f lc. -c
<br />a5 p, I l e' frk ; 'C
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