HomeMy WebLinkAboutCHRIST FELLOWSHIP CHURCH LOT 1 3850 ZIEGLER ROAD - Filed DCP-DEV. CONSTRUCTION PERMIT - 2004-07-19DEVELOPMENT CONSTRUCTION PERMIT
d APPLICATION
(1/7/99)
For City use only: Application Number: Application Date:
Permit application fee: S
INSTRUCTIONS:
1. Complete this form (some questions may not apply to you) and attach all necessary
documents and submit to the Development Engineering Section of the City.
2. If you have any questions contact the Development Engineer
at 221-6750.
3. Submit the Application and pay the Application Fee at the fee at the Engineering
counter at 281 No. College Avenue.
PROJECT INFORMATION:
Project Name (as approved by the City):
r
Project A.K_A. (Marketing name if different from Project Name):
Project Location: 3300 9ZF_&z ER zj6,4il
FT, excei-a/s s o Soy aS
Property Owner(At the time of this permit issuance);
Name: �ft2S7 FE s.vSro G .
Address: p. n . ,?D x 2 2 gA -7 FT !oc e- u c GO &o S-2 S�_
Phone numbe:r(s):
Office: -470) .;k /9 9 9
Cellphone: "
Fax number:
Email:
Applicant/Project Manager (The primary contact person for all matters regarding this project, and
the person responsible for all matters referencing "the Developer" in the Development Agreement for
this project):
Name: To(Job +IuA � AAj u
Address : y� mcA�bnvr 1R• L� VZT t/ ��y0 r
Phone number(s):
Office: _(g2Q)
Cellphone: 192t,�
Fax number: (qTy90 _Q9 g
Email:
Project Engineer (A Colorado licensed professional engineer who is the civil engineer the person
responsible for the design of this project, responsible for certification that improvements are
constructed in accordance with approved plans, responsible for making revisions to plans with City
approval and for providing as -constructed plans):
Name: s7E'kjhA7- -F /455 o GJrfT e 4
Address: 1Q 3 S. t;7zL4iRC261 ST FT. Coc / T S r n ae rs
Phone number(s):
Office: (-oH82— 933
Cellphone:
Fax number:
Email: _
Professional :License Number.
Developer (The party or parties referenced in the Development Agreement who are responsible for the
Developer's obligations contained in the Agreement -add additional names below):
Name: C#ersr FBtr�c�SrJIP ! Yc AGH
Address: __L o. Bo K a 7;Z S 6-7 FT e&",Z V 3 1-2gu c 5—
Phone number(s):
Office: A 70) ;k. r 9 - 19 4 `1
Cellphone:
Fax number.
Email:
General Contractor (The contractor in overall charge of the public infrastructure construction):
Name:1�),-i&A) C�.ySTRnaTrea/y r�,C•.
Address: may, r,.,rA /'oTwrr 1R /� Tr sF �T o c res��
Phone number(s):
Office: C9x7� NVD - ig5
Cellphone: C9xO)
Fax number: C9ae9 "go - Gd 9' 3
Email:
If you have no General Contractor, list all other contractors below.
Grading contractor:
Name: _
Address:
Phone number(s):
Office:
Cellphone: -
Fax number:
Email:
Utility contractor:
SUBMIT THE FOLLOWING ITEMS (Required for all projects):
• 81/2"xl1" copy of the Site Plan
• Proposed Project Schedule
• Project quantities and cost estimate for all of the public improvements to be constructed.
In addition, include all private improvements that are required to be inspected by the City
Construction Inspectors. This information must be submitted in the format shown on the
attached form titled "Project Quantities and Cost Estimate Sheet."
ADDITIONAL SUBMITTALS (Required if checked):
❑ Traffic control plan(s) for the project
❑ Proposed haul routes shown on a City map
❑ Shop drawings
❑ Other
CONSTRUCTION COORDINATION MEETING: A construction coordination meeting to
discuss plans and special requirements for your project, is required for all development projects. The
people required to attend the meeting are the Project Manager, Project Engineer, Developer,
Architect/Land Planner and General Contractor (if no General Contractor, representatives for each of
the contractors expected to work on this project)
People to Attend: List the peoples names and titles for those who will attend the pre-
construction meeting:
Name
Title
ESTIl4LATED COST OF INFRASTRUCTURE IMPROVEMENTS: Provide the estimated
value of all public infrastructure improvements that will be constructed and accepted by the City to
own and maintain. In addition provide the value of all private infrastructure improvements that the City
will inspect and require certification for. The estimate shall be in the same format as the attached sheet
titled "Project Quantities and Cost Estimate Sheet."
Public infrastructure, estimated cost: S JIS s�/s, 2 S
Private infrastructure, estimated cost: S `J aa
I certify that the information on this permit application along with the required additional submittals are
true and correct to the best of my knowledge, and that in filing this application I am acting with the
knowledge, consent, and authority of the owners of the property (including all owners having legal or
equitable interest in the real property, as defined in Section 1-2 of the City Code, and including common
areas legally connected to or associated with the property which is the subject of this application) without
whose consent and authority the requested action could not lawfully be accomplished. Pursuant to said
authority, I hereby permit City officials to enter upon the property for purposes of inspection and, if
necessary, to enter upon such property to perform work required of the applicant if the applicant were to
fail to perform the required work.
Applicant Signature:___/% Date: 12 113/o3
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