HomeMy WebLinkAboutBLD1988-00414 • N E
). LOCATION: geographic name S W SIDE OF III ROAD FEET
S W FROM INTERSECTION OF ROAD AND 5- / I/(UU,I 1T rf.kQ a), ROAD
•
other specific location or landmark: <) . s
LEGAL DESCRIPTION: IC( ` 1((7
Pii 2 z -`tP Lot Block Su ivision
''.-7 2s! 'JO ( '% Tax Number Y.Section Se Lion ownship Range 1
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE
❑New building ❑Single Family PUBLIC WORKS APPROVAL
❑Addition ❑Multi-Family
❑Alteration
number of units Road Access Permit No.
❑Repair,replacement ❑Hotel,Motel,Dormitory Utility Permit No.
number of units
❑Wrecking 0 Mobile Home j`Emergency Services No.
0 Moving(relocation) A i
Other—Specify t Street Width A;
❑Foundation only
(f--QUA1C�r B:
Additional Permits Required:
OWNERSHIP
❑Private (individual,corporation,
nonprofit institution,etc.)
❑Public (Federal,State or local govt.) UBC OCCUPANCY GROUP: ps)--
COST (Omit cents)
Nonresidential— Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
To be installed but not included school,secondary school,college,parochial school,parking garage for
in the above cost department store,rental office building,office building at industrial plant.
a. Electrical If use of existing building is being changed,enter proposed use.
b. Plumbing
c. Heting,air conditioning
d. Other(elevator,etc.) y
• TOTAL COST OF IMPROVEMENT $ f.
III.SELECTED CHARACTERISTICS OF BUILDING
t':
.j PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
Masonry (wall bearing) (] •Number of Stories
g Public or Private — •
Wood Framedividual Total square feet of floor area, E.
ptic tank,etc.) all floors,based on exterior
[0Structural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY *Total land area,sq.ft.
a... 0 Other—Specify 0 Public or private company
Jndividua (well cistern) NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
., 0 Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
0
Electricity Number of bedrooms
OCoal TYPE OF MECHANICAL
❑Other—Specify
Number of {Full
bathrooms
Partial t
—
IV. I ENTIFICATION t..
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
C7/ J7?T' 7`r 1)--A- , 7 6
2. > .pl a-- 4( 5/ `3'— v c
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Contracto GCC j
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Architect f
The owner of this building and the undersigned agree to conform to all applicable laws.
yriature of applicant Address I
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PLANNING AhEA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT i.
APPROVED B'Y APPROVED '3Y APPROVED DY i .
JEF _ rtie - TH •E- SHOPEL I NE DEPT. PLANNING DEPT.
APPROVED Y •,� PERMIT FEE ISSUE DATE
�. `" �141 _�(� RECEIPT NUMBER
7 'see 111101,I 3.CD 3/7 irs
BUILD� Nkb� �GIVTY7, CO I• ^
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