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HomeMy WebLinkAboutApplication- Permit-e ro 0 ti Permit No: GARFIELD COUNTY BUILDING PERMIT APPLICATION 108 8th Street, Suite 201, Glenwood Springs, CO 81601 Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003 9a9 Parcel/Schedule No: c2 ( — / 3 (1_ 00 - 0 AGREEMENT PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT. IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER AGREES THAT IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT SHALL BECOME NULL AND VOID. THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING OPERATION BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION. THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF ANY RESPONSIBILITIES OR LIABLITIES BY GARFIEID COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST. Garfom.003 I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL): Job Address: j75'D RQ.2yf (74-4E Go. 4-16,cf7 1 Lot No:3 Block No: Subd. / Exemption: 2wner: F6$Prk ROAv-oU/5 Address ('7&> PA 1 ! P: C., Ph: q762 91y0//Z Wk Ph: — 3 Contractor: Crete} Ce Address: g/6, Cie 3a) Ph: 9.70 (,g 99 22 Lk. No. 4 Architect/Engine r• Address: Ph: Lic. No. 5 Sq. Ft. of Building: Apra --et, ycn Sq. Ft. of Lot: 3 A C Height: No. of Floors: 6 t _ Use of Bu�d�ln�� Ponn. . cai 112; CA?t) l 4Ucs� tM Ck d 7 Describe Work: 8 Class of Work: ,❑, New o Alteration o Remove X Addition o Move 9 10 Garage: ❑ Single o Double Carport: o Single ❑ Double • ❑ Dri/vewayPermit 2s+././�:,I�L. R -❑ On ite Sewage Disposal ❑ Site Plan 'u slL N 'I •5 Aic) 11 I�TW't Valuation of Work. Adjusted Valuations: $ 1 -^I CZ oc ( 12 Special Conditions: us 1 leo, 5 28. h a* an A SEPARATE ISSUED THIS AUTHORIZED CONSTRUCTION PERIOD I HEREBY APPLICATION PROVISIONS COMPLETED GRANTING TO VIOLATE LOCAL OFC.. NOTICE ELECTRICAL PERMIT IS REQUIRED BY THE STATE OF COLORADO. PERMIT BECOMES NULL AND VOID IF WORK OR IS NOT COMMENCED WITHIN 180 DAYS, OR WORK I5 SUSPENDED OR ABANDONED OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CERTIFY THAT I HAVE READ AND AND KNOW THE SAME TO BE TRUE AND OF LAWS GOVERNING THIS TYPE OF WORK WITHIN WHETHER SPECIFIED HEREIN OF A PERMIT DOES NOT PRESUME TO OR CANCEL THE PROVISIONS OF ANY LAW REGULATING CONSTRUCTION OR THE RUC AND MUST BE CONSTRUCTION OR, IF FOR A EXAMINED THIS CORRECT. ALL WILL BE OR NOT. THE GIVE AUTHORITY OTHER STATE OR PERFORMANCE 0 . Plan Check Fee: 47 yT '"� j Permit Fee: 7 6n !y 2© .f 5 Total Fee: Dated Permit Issued: 99 /1 ' 1l g7.Z r /50GA t" 1"%'�q "! 2 CC Group: Const. Type: ^� / % `5- Of /y Zoning: Setbacks: 4-- / 2/27 4 Manu. Home: ISDS No. & Fee: /y'�y^1 OD y}� 6J�v •�r�r/// cb"I"-�-^/..-/ / f S ATU 'E F.� �� j l 14 3-11:00 !�/7/,I '/�/ fr BLDG DEa P s"Or APPROVA TE A %' .' ..I Orr AGREEMENT PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT. IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER AGREES THAT IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT SHALL BECOME NULL AND VOID. THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING OPERATION BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION. THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF ANY RESPONSIBILITIES OR LIABLITIES BY GARFIEID COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST. Garfom.003 I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL): PLAN REVIEW CHECKLIST Applicant Ptict9l.pJ Building A7. $ Engineered Foundation t_Driveway Permi 0,4, Surveyed Site Plan Septic Permit and Setbacks made/Topography 30% ,/Attach Residential Plan Review List Date 3-(6 0,1,,,V (&34 /3 a)4 puotit Minimum Application Questionnaire /44 Subdivision Plat Notes /64 Fire Department Review '' Valuation Determination/Fees ed Line Plans/Stamps/Sticker Aho Attach Conditions /plication Signed Plan Reviewer To Sign Application 198 Weil 40# Snowload Letter- Man£ Hms. • GENERAL NOTES: 4p©u 4,9 4 $a x 9 z A% x 7) 5/370 Planning/Zoning Property Line Setbacks 30ft Stream Setbacks Flood Plain Building Height Zoning Sign -off Road Impact Fees HOA/DRC Approval Grade/Topography 40% Planning Issues Subdivision Plat Notes Applicant .� Address /75D C I z / Date 3 , 7 05- Finished (Livable Area): Main Upper Lower Other 7o r-- N/FEE DETERMINATION Total Square Feet Valuation Subdivision Lot/Block Contractor 77c, ,Q 53, 544 Basement: Unfinished Conversion of Unfinished to Finished Plan Check Fee for Conversion Valuation Garage: Crawl Space: Valuation Valuation Decks/Patios: Covered Valuation Open Valuation Total Valuation 77(, ? Ton -t *to F >v Bo. 984 leo .522, 1,189.z4 978.80 2'O. 3c GARFIELD COUNTY BUILDING AND PLANNING 970-945-8212 MINIMUM APPLICATION REQUIREMENTS for SINGLE FAMILY DWELLING CONSTRUCTION including NEW CONSTRUCTION ADDITIONS ALTERATIONS and MOVED BUILDINGS In order to understand the scope of the work intended under a permit application and expedite the issuance of a permit it is important that complete information be provided. Adequate and complete information will prevent delays in the plan review process. Reviewing a plan and the discovery that required information has not been provided by the applicant may result in the delay of the permit issuance and in proceeding with building construction. The owner or contractor may be required to provide this information before the plan review may proceed. This causes delays because other plans that are in line for review may be given attention before the new info niation may be reviewed after it has been provided to the Building Department. Please review this document to determine if you have enough information to design your project and provide adequate information to facilitate a plan review. If you do not, it may be helpful to obtain a book titled "Dwelling Construction under the Uniform Building Code". This book is available to you through this department at our cost. Also, please consider using a design professional for assistance in your design and a construction professional for construction of your project. To provide for a more understandable plan in order to determine compliance with the building, plumbing and mechanical codes, applicants are requested to review the following checklist prior to and during design. Applicants are required to indicate appropriately and to submit the completed checklist at time of application for a permit. Plans to be included for a Building Permit, must be on drafting paper at least 18"x24" and drawn to scale. Plans must include a floor plan, a concrete footing and foundation plan, elevations all sides with decks, balcony, steps, hand rails and guard rails, windows and doors, including the finish grade line. A section showing in detail, from the bottom of the footing to the top of the roof, including re -bar, anchor bolts, pressure treated plates; floor joists, wall studs and spacing, insulation, sheeting, house - rap, (which is required), siding or any approved building material. A window schedule. A door schedule. A floor framing plan, a roof framing plan, roof must be designed to withstand a 40 pound per square foot up to 7,000 feet in elevation, an 80 M.P.H. windshear, wind exposure B, windload of 15 pounds per square foot, and a 36 inch frost depth. All sheets to be identified by number and indexed. All of the above requirements must be met or your plans will be returned. All plans submitted must be incompliance with the 1997 UBC, UMC and 1997 UPC. 1. Is a site plan included that identifies the location of the proposed structure or addition and distances to the property lines from each corner of the proposed structure(s) prepared by a licensed surveyor and has the surveyors signature and professional stamp on the drawing? Properties with slopes of 30% or greater must be shown on the site plan. NOTE: 106.3.1 (7.) Any site plan for the placement of any portion of a structure within 50 ft. of a property line and not within a previously surveyed building envelope on a subdivision final plat shall be prepared by a licensed surveyor and have the surveyors signature and professional stamp on the drawing. Any structure to be built within a building envelope of a lot shown on a recorded subdivision plat, shall include a copy of the building envelope as it is shown on the final plat with the proposed structure located within the envelope. Yes Does the site plan also include any other buildings on the property, setback easements and utility easements? Please refer to Section 5.05.03 in the Garfield County Zoning Resolution if the property you are applying for a building permit on is located on a corner lot. Special setbacks do apply. Yes 3. Does the site plan include when applicable the location of the I.S.D.S. (Individual Sewage Disposal System) and the distances to the property lines, wells (on subject property and adjacent pr perties), streams or water courses? Yes 2 4. Does the site plan indicate the location and direction of the County or private road accessing the property/ Yes 5. Do the plans include a foundation plan indicating the size, location and spacing of all reinforcing steel in accordance with the unifo nu building code or per stamped engineered design? / Yes 6. Do the plans indicate the location and size of ventilation openings for under floor crawl spaces andtI e clearances required between wood and earth? Yes 7. Do the plans indicate the size and location of ventilation openings for the attic, roof joist spaces's andrsoffits? Yes any 8. Do the plans include design loads as required by Garfield County for roof snow loads, (a minimum of 40 pounds per square foot up to & including 7,000 feet above sea level), floor loads and wind loads? Yes / 9. Does the plan include a building section drawing indicating foundation, wall, floor, and roof construction? Yes 10. Does the building section drawing include size and spacing of floor joists, wall studs, ceiling joists, roof riafrers or joists or trusses? Yes 11. Does the building section drawing or other detail include the method of positive connection of all columns and beams? Yes 12. Does the plant indicate the height of the building or proposed addition from the highest point of the building or addition measured at mid span between the ridge and the cave down to existing (und)sturbed) grade contours? Yes 13. Does the plan include any stove or zero clearance fireplace planned for installation including make and model and Colorado P17 -II certifications or phase II EPA certification? Yes No 3 14. Does the plan include a masonry fireplace including a fireplace section indicating design to comply with the Uniform Building ode Chapter 37? Yes No 15. Does the plan include a window schedule or other verification that egress/rescue windows from sleeping rooms and/or basements comply with the requirements of the Uniform Building Code? Yes t j No 16. Does the plan include a window schedule or other verification that windows provide natural light and ventilation for all habitable rooms? Yes I/ No 17. Do the plans indicate the location of glazing subject to human impact such as glass doors, glazing immediately adjacent to such doors; glazing adjacent to any surface normally used as a walking surface; sliding glass doors; fixed glass panels; shower doors and tub enclosures and specify safety glazing for these areas? Yes ✓ No 18. Is the location of all natural and liquid petroleum gas furnaces, boilers and water heaters indicated on the plan? Yes No 19. Do you understand that if you are building on a parcel of land created by the exemption process or the subdivision process, are building plans in compliance with all plat notes and/or covenants? Yes No 20. Do you understand that if you belong to a homeowners association, it is your responsibility to obtain written permission from the association, if required by that association, prior to submitting an application for a building permit? If you do not have written permission from the association, do you understand that the plan check fee will not be refunded should the architectural committee deny or reject your building plans? Yes ✓ No 21. Will this be the only residential structure on the parcel? Yes / No If no -Explain: 22. Have two (2) plete sets of construction drawings been submitted with the application? Yes 23. Do you understand that the minimum dimensions a home can be on a lot is 20ft.wide and 20ft. long? Yes No 4 24. Have you designed or had this plan designed while considering building and other construction code requirements? Yes No 25. Do your plans comply with all zoning rules and regulations in the County related to your properties zone district? Yes No 26. Does the plan accurately indicate what you intend to construct and what will receive a final inspection by the Garfield County Building Department? Yes v No 27. Do you understand that approval for design and/or construction changes are required prior to the application of these changes? Yes No 28. Do you understand that the Building Department will collect a "Plan Review" fee from you at the time of application submittal and that you will be required to pay the "Permit Fee" as well as any "Road Impact" or "Septic System" fees required, at the time you pick up your building pen -nit? Yes ✓ No 29. Are you aware that twenty-four (24) hour notice is required for all inspections? Inspections will be made from Battlement Mesa to West Glenwood in the mornings and from Glenwood Springs to Carbondale in the afternoons. All inspections must be called in by 3:30 p.m. the day before. Failure to give twenty-four (24) hour notice for inspections will delay your inspection one (1) day. Inspections are to be called in to 384-5003. Yes No 30. Are you aware that requesting inspections on work that is not ready or not accessible will result in a $47.00 re-inpsection fee? Yes No 31. Are you aware that you are required to call for all inspections required under the Uniform Building Code including approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy of the building? Yes No 32. Are you aware that the Permit Application must be signed by the Owner or a written authority be given for an Agent and that the party responsible for the project must comply with the Uniform Building Code? Yes No 5 33. Are you aware that prior to submittal of a building permit application you are required to show proof of a driveway access permit or obtain a statement from the Garfield County Road & Bridge Department stating one is not necessary? You can contact the Road & Bridge Department at 625-8601. Yes ✓ No 34. Do you understand that you will be required to hire a State of Colorado Licensed Electrician and Plumber to perform installations and hookups, unless you as the homeowner are performing the work? The license number of the person perfomling the work will be required at tim of applicable inspection. Yes No 35. Are you aware, that on the front of the Building Permit Application you will need to fill in the Parcel/Schedule Number for the lot you are applying for this permit on prior to submittal of a building permit application? Your attention in this is appreciated. Yes ✓ No 36. Do you know that the local fire district may require you to submit plans for their review of fire safety issues? Yes No (please check with the building department about this requirement) I hereby acknowledge that I have read, understand and answered these questions to the best of my ability. Signature of Owner Phone: /It,- 9 g` - O ,2— (days)//; pp Project Name: //C 8g4 7t a, (mss Project Address: Date (evenings) 17 57) Z (I/ /12,&iiroz tt lam; ct/e y Z Notes: If you have answered "No" on any of the questions, you may be required to provide this information at the request of the Building Official prior to beginning the plan review process. Delays in issuing the permit are to be expected. Work may not proceed without the issuance of a permit. If it is determined by the Building Official that additional information is necessary to review the application and plans to determine minimum compliance with the adopted codes, the application may be placed behind more recent applications for building permits in the review process and not reviewed until required information has been provided and the application rotates again to first position for review, delay in issuance of the permit or delay in proceeding with construction. bpminreq 11/2003 6 Garfield County Date: May 20, 2008 To: Robert Reynolds 1750 CR. 241 New Castle, Co. 81647 Dear Permit Holder, Please refer to your building permit number BUILDING & PLANNING DEPARTMENT 9242 , issued 8/23/2004 A routine review of our open building permits indicates that we have not received a request for an Inspection -on this permit since-. 10/6/2005 Please be advised that building permits expire, per Uniform Building Code, section 106.4.4 and International Code Section 105.5 " Every permit issued by the building official under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work work authorized by such permit is suspended or abandoned at any time after the work has commenced for a period of 180 days. Before such work can be recommenced, a new permit shall first be obtained to do so, and the fee therefore shall be one half the amount required for a new permit for such work, provided no change have been made or will be made in the original plans and specifications for such Work, and provided further that such suspension or abandonment has not exceeded one year. In order to renew action or a permit after expiration, the permittee shall pay a new full permit fee." Please contact this office at your very earliest convenience, in writing, to advise us about the status of your permitted work. If you have not responded within thirty (30) days from the receipt of this notice the permit will be closed and a permanent notation will be placed in the property records at the County Clerk and Recorders office that indicates that the work permitted per Colorado Revised Statues 30-28-205 & 210, was not inspected, is not approved and the building or area is illegal to occupy and is subject to legal abatement action. Thank you for your cooperation. Sincerely, Jim Wilson Building Inspector 108 Eighth Street, Suite 401 • Glenwood Springs, CO 81601 (970) 945-8212 • (970) 285-7972 • Fax: (970) 384-3470 COUNTY OF GARFIELD - BUILDING DEPARTMENT CORRECTION NOTICE 109 8th St. Suite 303 Glenwood Springs, Colorado Phone 945-8212 Job located a Permit No. I have this day inspected this structure and these premises and found the following corrections needed: 7Gufr5re / r, igtedar- ras*-2) 44; ragratH pg6fsse viw ‘fr( 1----cf-$. You are hereby notified that the above correction must be inspected before covering. When corre ion(s) hav been made, call for in . p= tion. 7o[b CI 21/ Date Phone 945-821 Pi* Building Inspector INSPECTION WILL NOT BE MADE UNLESS THIS CARD IS POSTED ON THE JOB 24 HOURS NOTICE REQUIRED FOR INSPECTIONS BUILDING PERMIT GA FIELD COUNTY, COLORADO Date Issued / t '"" ' Zoned Area Permit No !'w!'i ew. AGREEMENT In consideration of the issuance of this permit, the applicant hereby agrees to comply with all laws and regulations related to the zoning, location; construction and erection of the proposed structure for which this permit is granted, and further agrees that if the above said regulations are not fully complied with in the zoning, location, erection and construction of the above described structure, the permit may then be revoked by notice from the County Building Inspector aQd IMMEDIATELY BECOME NULL AND VOID. / 00 , der—C,.. Use Address or Legal Descri • ion Setbacks Front - Side Side Rear This Card Must Be Posted So It is Plainly Visible From The Street Until Final Inspection. INSPECTION RECORD Footing 9...2/4,, -.ps Foundation R -a,q tray/ 41,g0 % ici -f /'-cij d Underground Plumbing Insulation 9_ZZ-D5 igi1ti--- RoughPlumbing 6-3_o,SF rn Drywall (0,49,Bs _j Chimney & Vent 6-3-05- on Electric Final (by S is ector),z%; / ., Gas Piping • l Final 7,9,-ogQ- --- Electric Rough (By State inspectory( ?Qh,,9/,Septic Final Framing qFoy- f / (To include Roof in place and Windows and Doors installed). Notes: ALL LISTED ITEMS MUST BE INSPECTED AND APPROVED BEFORE COVERING - WHETHER INTERIOR OR EXTERIOR, UNDERGROUND OR ABOVE GROUND. Phone 384-5003 APP D THIS PERMIT IS NOT TRANSFERABLE 109 8th Street County Courthouse Glenwood Springs, Colorado. DDO NOT DESTROY THIS CARD By F PLA ED OUTSIDE CO R WITH CLEAR PLASTIC Date: May 20, 2008 To: Robert Reynolds 1750 CR. 241 New Castle, Co. 81647 Dear Permit Holder, Please refer.to your building permit number BUILDING & PLANNING DEPARTMENT 9242 , issued 8/23/2004 A routine review of our open building permits indicates that we have not received a request for an inspection on this permit since 10/6/2005 Please be advised that building permits expire, per Uniform Building Code, section 106.4.4 and International Code Section 105.5 " Every permit issued by the building official under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work work authorized by such permit is suspended or abandoned at any time after the work has commenced for a period of 180 days. Before such work can be recommenced, a new permit shall first be obtained to do so, and the fee therefore shall be one half the amount required for a new permit for such work, provided no change have been made or will be made in the original plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year. In order to renew action or a permit after expiration, the permittee shall pay a new full permit fee." Please contact this office at your very earliest convenience, in writing, to advise us about the status of your permitted work. If you have not responded within thirty (30) days from the receipt of this notice the permit will be closed and a permanent notation will be placed in the property records at the County Clerk and Recorders office that indicates that the work permitted per Colorado Revised Statues 30-28-205 & 210, was not inspected, is not approved and the building or area is illegal to occupy and is subject to legal abatement action. Thank you for your cooperation. Sincerely, Jim Wilson Building Inspector R3VIC,K1 C t2 /N g iJ r LL ? z /41 3J &X") 108 Eighth Street, Suite 401 • Glenwood Springs, CO 81601 (970) 945-8212 • (970) 285-7972 • Fax: (970) 384-3470 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 Permit Glenwood Springs, Colorado 81601 Phone (303) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Namel System Location Legal Description of Assessor's Parcel No. SYSTEM N2 3994 Assessor's Parcel No. This does not constitute a building or use permit. Present Address Required Absoi Special Setbac Date FINAL SYSTEM IN Call for Inspection (; System Instal Septic Tank Septic Tank Ci0Sit 0 _ 4 -_ Septic Tank Access within 8" of surface Absorption Area �- Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other _Other ns (or other) Date_ Inspector �r' ' c'ry / �� :ONDITIONS: RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 1. All installation must comply 25, Article 10l Revised all requirements C.R.S.CRScomp.y with al 1e, of the ter 2. This is v Colorado State Board of nection to valid only for connection toHealth Individual 3.Anypermit of the thanydwelling connection structures structures uwhich h ve fully complied with Cou SewageDisposal requiy rnenttems C Con- requireme ctontn permit and causer for both action by the Building County zoning who constructs, 9f thZp Y Hing and building variation from the termsalters, or installs and revocation Hing office shallg requirements. Con- requirement or specifications contained of the permit. automatically be a violation or a n jail or both). an individual in sewage disposals the application of system in a manner which involves White- Permit commits a Class I, Petty a knowing 0� material Offense ($500, fine — 6 APPLICANT Yellow-DEPARTner.,,- 3pter Con- n or a aterial ie -6