HomeMy WebLinkAboutApplication - PermitGarfield County
Building & Planning Department
108 8th Street Suite 401 I -
Glenwood Springs, CO 81601·
Phone: (970)945-8212 Fax: (970)384-3470
Project Address Parcel No.
2425CR137
Glenwood Springs, CO
212324200176
Owner Information Address
2425CR137
Subdivision
Robert Oddo Glenwood Springs CO 81601
' . ' t
Permit NO. SEPT-5-10-1567
Pennit Type: Septic Permit
Work Classification: New
Pennit Status: Active
Issue Date: 6/4/2010 Expires: 06/04/2011
Section Township Range
Phone Cell
970-945-1006
Contractor(s) Phone Primary Contractor Required Inspections:
Proposed Construction I Details
FEES DUE
Fee
Septic Fee -New
Total:
Friday, June 4, 2010
Amount
573.00
$73.00
Valuation: $ 0.00
Total Sq Feet: 0
FEES PAID
Inv Total Paytype Amt Paid Amt Due
Inv# SEPT-5-10-20251
S 73 00 Credit Card $73.00
$ 0.00
Forln1pectlona call: 1 {888)868-5306
Inspection IVR
See Permit Record
Building Department
Copy
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GARFIELD COUNTY SEPTIC PERMIT APPLICATION
108 81h Street, Suite 401, Glenwood Springs, Co 81601
Phone: 970-945-8212 /Fax: 970-384-3470 I Inspection Line: 970-384-5003
www. arfield·countv .com
Parcel No : (this infonnation is available al !he assessors office 970.945-9134)
Lot Size : Subd./ Exemption :
Mailing Address Ph : Alt Ph :
"=24'-'~ cfZ.. I~~ 6w .s co tftl-'$---.1u1 --~''o ~.,..,
Mailing Address Ph : Alt Ph:
Alt Ph:
-10or,
( ) Repair
8 WASTE TYPE: Dwelling )Commercial or ind ustrial )Non· Domestic wastes
)Other-Desaibe ________________________ _
9 BUILDING OR SERVICE TYPE: ---------1------------------....,.....,._..
Number of bedrooms Garbage Grinder ( )Yes ~o
IO SOURCE & TYPE OF WATER SUPPLY: MWELL ( )SPRING { )STREAM OR CREEK ( )CISTERN
If supplied by COMMUNITY WATER, give name of suppl ier: ,...,
11 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: __________________________ _
Was an effort made to connect to the Community System?
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12 GROUND CONDITIONS:
Depth to 111 Ground Water Table
13 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED:
()(1Septic Tank ( )Aeration Plant ( )Vault
( )Recycl ing, Potable Use { )Recyding , other use ( )Pit Privy
Other· Describe
14
( )Underground Dispersal
Percent Ground Slope. ______ _
)Vault Privy
)Incinerati on Toilet
)Above Ground Dispersal
( )Composting Toilet
( )Chem ical Toi let
( )Evapotranspira ti on { )Sand filte r
FINAL DISPOSAL BY:
~Absorption trench, Bed or Pit
( )Wastewater pond ( )Other-Desaibe _________________________ _
IS Will effluent be discharged dlrectly Into waters of the state 1 ( )YES )(lNO
16 PERCOLATION TEST RESULT: (lo be completed by Regis tered Professional Eng111eer, if the Engineer does l he Percolation Tesl)
Minutes per inch in hale No.1 Minutes per inch in hole No.3
Minutes per inch · hole N .2 .MiQutes per inch in hole No._
Name, address & telephone of RPE who made soil absorption test:~~ ........ YP'rd~ad'ro~I-:-· &~.,---=-----.r~-----:---
Name, address & telephone of RPE responslble for design of the system : .#
17 Applicant acknowledges that the completeness of th e application is conditional upon such further ma datory and additional test and reports as may be required b
the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and
issuance of the permit is subject to such terms and cond itions as deemed necessary to insure compliance with rules and regu lati ons made, information and
reports subm itted herewith and required to be subm itted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief
and are designed to be relied on by the local department of health in evaluaUng the same for purpos s of issuing the permit applied for herein. I further
understand that a s 1c · n or misre entati 11 in the denial of the application or r ocation of a permit granted based upon said application
and legal actio for petj as ovided S ? (5 f)
OWNERS SI
STAFF USE ONLY
Permit Fee: Building Permit #: see Perk Fee:
btl16,
Total fees:
Septic Permit #: Issue Date:
Building & Planning Dept:
,d~
APPROVAL DATE