HomeMy WebLinkAboutApplication0 Alteration
0 Repair
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
ONSITE WASTEWATER
TREATMENT SYSTEM
(OWTS)
PERMIT APPLICATION
TYPE OF CONSTRUCTION
New Installation
WASTE TYPE
Dwelling
0 Transient Use
0 Comm./Industrial 0 Non -Domestic
0 Other Describe
INVOLVED PARTIES
Property Owner: ANNE
1I11K - -„S(,
Phone: (117c ) .2 -7'lD
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54.. Alit t 6) 1145
5`”"
Mailing Address: 75— 0, /041,
,
aiin Phone: ( f'7c')27y `1. To 6,
Contractor:
,V1.,'iv{f/
Mailing Address: 5-75- t,-) 3 4k 6 it &, 1 g!G S'
Engineer: Phone: ( )
Mailing Address:
PROJECT NAME AND LOCATION
Job Address: 713 17-
Assessor's Parcel Number:
Building or Service Type:
Distance to Nearest Community
Wasan effort made to
212 73 Wv7' Sub. Lot Block
140u #Bedrooms: Garbage Grinder IV
Sewer System:
connect to the Community
5— J1/1,(C.--
Vl,(GWas
Sewer System:
Vi 0
Type of OWTS
C,tif Septic Tank 0 Aeration Plant 0 Vault
0 Vault Privy I 0 Composting Toilet
❑ Recycling, Potable Use
0 Recycling 0 Pit Privy 0 Incineration Toilet
❑ Chemical Toilet
0 Other
Ground Conditions
Depth to ft Ground water table
YVt4A.
Percent Ground Slope _'T
Final Disposal by
O Absorption trench, Bed or Pit Underground Dispersal
O Evapotranspiration
0 Wastewater Pond
0 Sand Filter
Above Ground Dispersa
O Other
Water Source & Type
Effluent
Well
0 Spring
0 Stream or Creek
0 Cistern
O Community Water System Name
Will Effluent be discharged directly into waters of the State?
0 Yes
No