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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
Permit
Assessor's Parcel No.
This does not constitute
a building or use permit.
PROPERTY j� 1
Owner's Name J�I5 rI poleSPresent Address of q / ri<gorCT, ?;if *5-J-
3 jJ]�►
[Phone
System Location f 4-�t r sp./ it �¢ C. S / T ) 65-
Legal Description of Assessor's Parcel Ne LOY-r ` c& r 00t`"c{`tpkfrz..
SYSTEM DESIGN
/ 1)0 O Septic Tank Capacity (gallon) Other
SLI Percolation Rate (minutes/inch) Number of Bedroomsr(forpther) 3)65D
D
rr[l
Required Absorption Area - See Attached
.5 ?.' Li1c.,, v40_-1
Special Setback Requirements: 6, 2A VI In. b lQ
Jar
Date Inspector / A -(t f 1/- (?
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
-471
System Installer
Septic Tank Capacity
Septic Tank Manufacturer or Trade Narne
Septic Tank Access within 8" of surface
Absorption Area /I
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other
Date Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a
requirement of the permit and cause for both legal action and revocation of the permit.
3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine --- 6
months in jail or both).
White - APPLICANT Yellow - DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER C,ur\ es R .` U,cly
ADDRESS k S r PHONE . 3 2 g Q
CONTRACTOR _j� (,� � ,78c C n6.15,,!1 , _
ADDRESS 4/ 3 a /AI- o PHONE :1., 6 0 N C
tAvt
PERMIT REQUEST FOR NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable
building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY:
Near what City of Town S. ; / 1 Size of Lot / 0 A
Legal Description or Address / / /� c{ y1
WASTES TYPE: (X) DWELLING
11 Q� t r c. kc r• C D(? L61rK5f
( ) TRANSIENT USE �_ f
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER — DESCRIBE
BUILDING OR SERVICE TYPE: S
Number of Bedrooms
(. Garbage Grinder (A) Automatic Washer
D1I d, 4.c1
Number of Persons
jo.d (-1),(1
(-*�) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: P 4 55 E H n »; C wire 's' 4" d 0
710
(4OA
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: ow,' ,,., a c ] 1 -
Was
Was an effort made to connect to the Community System? A) 0
A site plan is required to be submitted that indicates the following MINIMUM distances:
Leach Field to Well:
Septic Tank to Well:
Leach Field to Irrigation Ditches, Stream or Water Course:
Septic System (septic tank & disposal field) to Property Lines:
100 feet
50 feet
50 feet
10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table Jv c7 vj q r E
Percent Ground Slope / o
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(x) SEPTIC TANK ( ) AERATION PLANT
( ) VAULT PRIVY ( ) COMPOSTING TOILET
( ) PIT PRIVY ( ) INCINERATION TOILET
( ) CHEMICAL TOILET( ) OTHER -DESCRIBE
FINAL DISPOSAL BY:
ABSORPTION TRENCH, BED OR PIT
UNDERGROUND DISPERSAL
ABOVE GROUND DISPERSAL
OTHER -DESCRIBE
VAULT
RECYCLING, POTABLE USE
RECYCLING, OTHER USE
( ) EVAPOTRANSPIRATION
( ) SAND FILTER
( ) WASTEWATER POND
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? /1( 0
PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the
Percolation Test)
Minutes
Minutes
_per inch in hole No. 1
per inch in hole No. 2
Minutes
Minutes
per inch in hole No. 3
per inch in hole No.
Name, address and telephone of RPE who made soil absorption tests:
Name, address and telephone of RPE responsible for design of the system:
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and
additional tests and reports as may be required by 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 the issuance of the permit is
subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made,
information and reports submitted herewith and required to be submitted 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 evaluating the same for purposes of issuing the permit applied for herein. I further understand that any
falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based
upon said application and in legal action for perjury as provided by law.
Signed ! c,(it
PLEASE Dv,
rel Date
AN ACCURATE MAP TO YOUR PROPERTY!!
3
KURTZ & ASSOCIATES, INC.
5012 County Road 154
Glenwood Springs, CO 81601
STRUCTURAL CONSULTANTS
Phone + Fax (970) 945 6305
MEMORANDUM
Date: September 13, 2011
Ca1o)244-i2i+
To: Jan Phillips
c/o: Co!dwell Banker Home Owners Realty
2499 Highway 6 & 50
Grand Junction, CO. 81505
Re. Residence @ 129 Larkspur Court, Silt Mesa,
Garfield County, CO.
At your request, I performed a structural inspection of the noted property on
09/09/2011. Prior to that inspection I reviewed the file for the property at the Garfield
County Building Department.
As you know, no Certificate of Occupancy (C,O.) has ever been issued for the
residence.
The original building permit for the residence and the attached garage was issued
by Garfield County on 06/27/2005. On 08/12/2205 Garfield County received and
approved a revised set of documents for the garage. The revised documents illustrate a
storage loft above the garage.
The residence is a single story UBC/LRC type modular residence erected on a
permanent, cast -in-place, concrete foundation. The upper level above the garage has been
constructed and partially finished as a one bedroom apartment, rather than as the
permitted storage loft.
To resolve the outstanding issues it will be necessary to apply for a new building
permit, resolve all outstanding issues, and obtain, after appropriate inspections and
approvals, a C.O. for the residence and the garage plus apartment.
This process is complicated by the non-confoming apartment. After discussing the
issues with Garfield County's Chief Building Official, Andy Schwaller, it is apparent that
there are two distinct options available.
One option is to apply to the Garfield County Building and Planning Department
for the right to construct an Auxiliary Dwelling Unit (ADU) on the property. The
apartment would qualify as the ADU. In that the property consists of 10.25 acres, it
appears likely that this application would be successful. It will be necessary to verify that
the water and sewer (septic system) systems are adequate to serve both the residence and
the apartment. After completion of the building and planning process, one would then
apply for a building permit to complete the garage and apartment.
2
Alternately, the Garfield County Building will allow one to apply for a C.O. for the
residence and exclude the garage and apartment. In this case, the county would, more
than likely, require within a specific time frame, that a zoning application and building
permit for the garage and apartment be obtained.
Our office will issue, as soon as possible, specific specifications and construction
documents which will address items necessary to obtain a C.O. for the residence, and for
the garage and apartment.
Attached to this memo is a check list provided to the original property owners
listing standard final inspection requirements.