HomeMy WebLinkAboutOnline Form Submittal_ PERMIT APPLICATION Foundation Repair_Page_2Wheat Ridge
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
Address
Retype Contractor
Email Address
DESCRIPTION OF WORK
Location of Work
719-428-4925
ellen.roche@groundworks.com
ellen.roche@groundworks.com
Foundation repair on North and West side of home
How is repair being Push & Helical Piers
done? Piers, strips, etc.
# of Piers or Strips 16
Upload engineer letter 3868 Estes St Obversation Letter ndf
or pages on 8 1/2" x
11" only
Repair Plan Set on 3868 Estes St drawinas ndf
11 "x17" only - if
applicable
Project Value (contract 43,000
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.