HomeMy WebLinkAbout202201645 - 4135 Ammons St - Application_Page_1From:
no-reolvCalci.wheatridae.co.us
To:
CommDev Permits
Subject:
Online Form Submittal: REVISION APPLICATION Revisions to Permit
Date:
Friday, July 22, 2022 2:23:14 PM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
REVISION APPLICATION Revisions to Permit
Permit Number 202201645
assigned to project
PROPERTY INFORMATION
Permit Number
202201645
Property Address
4135 AMMONS ST
Property Owner Name
MAX ROUMPH
Property Owner Phone
719-242-1992
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Field not completed.
Address
CONTRACTOR INFORMATION
Contact Name
JASON LAMB - TRENCH RIGHT
Contact Phone Number
303-287-9009
(enter WITH dashes,
eg 303-123-4567)
Contact Email Address
OFFICE@TRENCHRIGHT.COM
Retype Contact Email
OFFICE@TRENCHRIGHT.COM
Address
DESCRIPTION OF WORK
Detailed Revised DIGGING ADDITIONAL 18' FROM PREVIOUS TRENCH FOR
Scope of Work - SEWER REPAIR
Provide a detailed
description of the
change in scope of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc
Engineer Letter (if Field not completed.
applicable)
Additional Documents Field not completed.
on Letter Size
Are plans or No plans needed
documents locked for
editing?
Construction Plans Field not completed.
scanned on 11'x17" or
larger
Additional Project 9500
Value Only add what
the revised scope of
work is valued at.
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Submitting JASON LAMB
Revision
Email not displaying correctly? View it in your browser.
From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Sewer or Water Line Repair
Date: Wednesday, July 20, 2022 10:28:53 AM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
PERMIT APPLICATION Sewer or Water Line Repair
This application is exclusively for SEWER OR WATER LINE REPAIR -IN YARD
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Right of Way permits must be applied for with the Public Works Department.
Is this application for Yes
sewer line or water line
repair - in yard only?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 4135 AMMONS ST
Property Owner Name MAX ROUMPH
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
719-242-1992
Field not completed.
CREDIT AUTH FORM 7.20 O.Ddf
CONTRACTOR INFORMATION
Contractor Business TRENCH RIGHT
Name
Contractor's License 130022
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 303-287-9009
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email OFFICE@TRENCHRIGHT.COM
Address
Retype Contractor OFFICE@TRENCHRIGHT.COM
Email Address
01:K163CiIi1 ffl0N]&TO(6]S:/
Is this a sewer line or
Sewer Line
water line repair?
Length of repair
8'
Location of repair
FRONT YARD
(backyard, frontyard,
etc)
Provide additional
INSTALL CLEANOUTS
details including
installation of clean -
outs.
Project Value (contract
5850
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for JASON LAMB
Pe rm it
Email not displaying correctly? View it in your browser.