HomeMy WebLinkAboutApplication-PermitGARFIELD COL]NTY SEPTIC PERMIT APPLICATION
108 8th Street, Suite 401, Glenwood Springs, Co 81601
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-3 84-5003
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Cr Streetor &Name or andaddressannothasbeenCity)legal descriptionJobAddress(if assigned,provide Hwyplease a)34 ?tu*y
Parcel No: ltnis at the assessors office 970-945-91
Block No:Su
AIt Ph:Mailing Address eìen Wr,OclqNêI ll7 Qi> ï¡r,n1t Co!)tet
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4 Owner: (properly owner)
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Conlractor:
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Ph:AII Ph:Mailing Addreıs I6Engineer:
7 PERMIT REQUEST FOR ( ) New lnstallation (f) Alteration fif RePair
({)Dwdling
( )Other -
( )Non- Domestic wastes( )Transient Use ( )Commercial or industrialWASTE TYPE
9 BUILDING OR SERVICE TYPE:
Number of bedrooms Garbage Grinder ({Yes ( )No
l0 (nwELL ( )SPRTNG ( )STREAM OR CREEK ( )CISÏERN
lf supplied by COMMUNITY WATER, give name of suppl
SOURCE & TYPE OF WATER SUPPLY:
ll 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
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Depth to 1,t Ground water raolel 99-kl-GROUND CONDITIONS:150Percent Ground
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($Septic Tank ( )Aeration Plant ( )Vault( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy
TYPE OF |NDTVTDUAL SEWAGE DISPOSAL SYSTEM (ISDS)PROPOSED:
( )Other-
( )Composting Toilet
( )ChemicalToilet
( )Vault Privy( )lncineration Toilet
l4 FINAL DISPOSAL BY:
( )Absorption fench, Bed or Pit
( )Wastewater pond
(¡)Underground Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter( )Other- Describe
l5 be discharged directly into waters of the state ffiru0
l6 PERCOLATIQN TEST RESULT: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test)
Minutes-perinchinholeNo'1Minutes-perinchinholeNo.3Minutes-perinchinholeNo.2Minutes-perinchinholeNo.-
Name, address & telephone of RPE responsible for design of the system:
Name, address & telephone of RPE who made soil absorption
be iredconditionalISsfurtheruchandtestadditionalandthatesthetheofmandatoryreportsmayrequ bycompletenessapplicationup0nacknowledgApplicant
thelocalthehealthfortheofofevaluationtheandbetoandmadefurnìshedtheapplication;0rthehealthlocalapplicant by department purposeddepartmentby
ruleswith and ulations andinformationandtermsdùconditionsdeemedtorensumade,uanceiss theof is to such necessary compliance regpermitsubject
and beliefareicantwill0rbebetoandtruetocorrectbesttheofherewithsubmittedandbetoittedsubmthemyknowledgebyapplrepresentedreportsrequired
tssof the herein.for furtherlocaltheofinhealththeforsameevaluatingrp0sesurngappliedpermitpuareandnedtobedepartmentdesig
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lawandforactionlegalby
DATEOWNERS SIGNATURE
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TAFF USE
Total feesãc Building Pcrmit
N hSOPermit Fee Perk Fee:
O
Issue Date:Septic Permit
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DATEAP
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PRoPERTY f1p.ì¡ ë1tttrþfl{l
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 401
Glenwood Springs, Colorado 81601 Permit
Phone (g7o) 945-8212 Assessor's
45S$ :!
Parcel No
INDIVIDUAL SEWAGE DISPOSAL PERMIT This does not constitute
a building or use permit.
MU present Address [_\ï:ç\ C F. \ fi_Phone ft.r:';-) 5t[1,
Legal Description of Assessor's Parcel No.
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I\tr:\"-("535 û** ç1ä þr
SYSTEM DESIGN
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Owner's Name
System Location
/tr
Septic Tank Capacity (gallon)
Percolation Rate (minutes/inch)
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i-..L
Other
Number of Bedrooms (or other)-J.I
¡.-\
Requ
Speci
Date
ired Absorption Area - See Attached
al Setback Requirement, Ç'/Å""'" "] t p
/S ", rr-" c'r $ |
( rv")
r ^^ ,,1'l( *./ ."/
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Callfor lnspection (24 hours notice) Before Covering lnstallation
System lnstaller F*rÃ.,Å,,s F- Y.r1]:."{,
Septic Tank Capacity
/:t
t-:þ
Septic Tank Manufacturer or Trade Name (::7eþ/;kf'*{¡t"/,8 d:
Septic Tank Access within B" of surface vÆ.s
f- ..ft'
Absorption Area *f î? ¡!, ^5 6) , ,F: !' r'',Çt'î:i'x,-s";'
Absorption Area Type and/or Manufacturer or Trade Name
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4" t#' q-"" /f'.¡rt,
Adequate compliance with County and State regulations/requirements
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r:,-{*-.Other
Date
'|")t L-t
*-r''T** #lnspector
RETAIN WITH RECEIPT DS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health lndividual 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. Connection 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,gystem in a manner which
- involves a knowing and material variation from the terms or specifications con'tained in the application of
permit commits a Class 1, Petty Offense ($500.00 fine - 6 months in jail or both).
White - APPLICANT Yellow - DEPARTMENT
PARCEL BPROPOSED PROPERTYDIVISION 2,08 ACRESTO BÊ SElREBAR AND CAPL.s. N0- 26950s 52'56'57" E_!_g_s'_39"09:_!Y--PARCEL A4.OO ACRES15.45'TOSETAND CAP26950YE ffiK.-ìirlliilr¡91llijrllrilrlrlirlllj¿iiijilirlIIIlIIl'I1IIITO BE SÊTREBAR AXO CAPL.S. NO.:6950IItilFd.JNDRÊBAR & CAP lt@ÆsTLLECABLE rO ÞÆÉ Bs 3s'45'05" E28.68'I1.25 ACRES OF40% OR LTSSSife Plan*ÉE¡SOt2' fr*FOUND4IREBAR & CAPP.LS. #3317ELEV. = 4t¡2.8'.od-ìì(¿ ..."ì-1":.JA1.OARCHITECTiJSERVlÞ\uYl[ıcy & Wll¡ãa Flood Rlsld.ñc€4339 ForMilè Rod3lenwood S:- ngs, ColoradoGARFIEÚ, COUNÛE9¡a
Parcel Detail Page 1 of3
Resiùe_ntia.l¿C-ommerciallmprovementDetail
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Garfield County Assessor lTr easurer
Parcel Detail Information
Assesso/Ireasurer Property Search I Assessor Subset Qucry I Asscssalsalçs S€alqh
Clerk & Recorder Reception Search
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Land Detail I
Sales Detai_l I
Phqtasaphs I
Tax Area
008
Account Number Parcel Number 2007 Mill
F(04st22 239503300052 60.596
Owner Name and Mailing Address
SPIDELL, MARK V/. & ELIZABETH FLOOD
4339 COI-INTY ROAD I17
GLENV/OOD SPRINGS, CO 8160I
Assessorts Parcel Description
(Not to be used as a legal description)
Location
SECT,TWN,RNG:3-7-89 DESC: A PARCEL
THE SWSW. PARCEL A IN FLOOD
UB-DIV EXEMPTION. DESC: & E OF V/
OF SEC.3 PRE:R080085 BK:0493
PG:07 1 9 RECPT:742828 RECPT :7 42827
BK:1216 PG:3 RECPT:571797 BK:1046
:815 RECPT:517938
Township Range
Address:339 IT7 COUNTY RD GLENV/OOD SPRINGS
Subdivision:
Land Acres:
Ft:Land
Section
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Parcel Detail Page2 of3
7J 89
2008 Property Tax Valuation Information
Additional Value Detail
Most Recent Sale
sale Date: llzttttzoog
Sale Price: lls+q,zoo
Basic Building Characteristics
No Building Records Found
Tax Information
No Tax Records Found
Mill Levy Revenues Detail
Land:
A.ctual Value
160,000
Assessed Value
r2,740
339 8
Total:499,00 39,72
Number of Residen 0
Number of
Tqp-otPags
Assessor Database Search Options I Treasurer patabase Search Options
Clerk & Recorder Database Search Optioag
QarüsjüCoulry-H-onqlage
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Parcel Detail
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