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HomeMy WebLinkAbout02932 • • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2932 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY L Q� T • /� Owner's Name mt a dCL,$ tMkv 4� ent Address 135 CR / a (OL S t IT Co Phone f) f �_�" v • System Location (35 `ntrti-ti kind Kh ad € SA O ) C A 1b5 r� J Legal Description of Assessor's Parcel No. 1) ttoC LC c f, Dt O C.2.14- Loch �' 7s'6 SYSTEM DESIGN 1) 4* or V Kr! Y -Caen -chatOE& OED �} SYp c. 00 0 Septic Tank Capacity (gallon) `-� Other 3 78 rr Mi Percolation Rate (minutes /inch) Number of Bedrooms (or other) Required Absorption Area - See Attached Special Setback Requirements: u y _ Date 7 a I nspector A FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer tail -)F E. Septic Tank Capacity 2 XO //1i Septic Tank Manufacturer or Trade Name t'O,LAIf'Q. Septic Tank Access within 8" of surface 4 Absorption Area 3 7 B # Absorption Area Type and /or Manufacturer or Trade Name 5 4E if Iti ylbs i6 8 / Adequate compliance with County and State regulations /requirements 9ES Other o, Date ,5 "r�s1 - 97 Inspector 44 / \or `rla.d RETAIN WITH RECEIPT RECORDS AT CONSTRU 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 Witheny dwelling or structures not approved by the Buliding 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 Ina 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 24207 0-- /k477/6-9Z 7 0 WAS ADDRESS 13 5 - 02 2.66 Si /7 8i6sz. PHONE 8 76 -- 1/10 CONTRACTOR F ADDRESS PHONE PERMIT REQUEST FOR ( ) NEW INSTALLATION ( ) ALTERATION (a4 REPAIR ccc Attach separate sheets or report showing entire area with respect to surrounding areas, topography o 4 area, n FIE") habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4). LOCATION OF PROPOSED FACII JTY; Near what City of Town S 1 t I Sits of Lot Legal Description or Address 1 33 C.. i2 2 6 6 S i LT CO 51/652- WASTES TYPE: (>) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: P1 ©D U L. 412 II o.= C- Number of Bedrooms 3 Number of Persons z (k) Garbage Grinder ()) Automatic Washer (\') Dishwasher SOT MCP. AND TYPE OF WATER SIMPLY: (X1 WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: OA/KNowA) - Nc,uc- iN AacS4 Was an effort made to connect to the Community System? WO — NoNc i N A acA A site plan is required to be submitted that indicates the following MINIMUM distances: Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL, SEWAGE DISPOSAL SYSTEM PERMIT WILL, NOT BE ISSUED WITHOUT A SITE PLAN, GROL INI) CONDITIONS: Depth to first Ground Water Table Percent Ground Slope ; 2 . (o tab ���� TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: • (X) SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE FINAL DISPOSAL BY: ( ) ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION (>0 UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER - DESCRIBE // WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? NG PERCOLATION TEST REST TITS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes per inch in hole No. 1 Minutes per inch in hole NO. 3 Minutes per inch in hole No. 2 Minutes 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 „ / - r - Date PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! SeG G,4cK 3 { 0 , • . . k to &$ | n { ƒ / § ■ » & # \ / _ 0 \ so k \ a f * 0 & o § / kƒ§ -�- e. $ n ° r \�\ƒ _ \ ( � 8 \% f § j a % [ \ / 0. I > § � . 7! \2 }k . i a[ k /] & \ \ ]k 0, 4 � \ 2 � . A 4 } § § �) 2e g- k £7 . r C. 2 §] 9 � 7 � � $ 5 ■ p { o 0 - k t P> • $ ® ,ja 0 FL it/M , Po • C 4 R ■ I k • , 15 ba 10 ri 0 GO IS at e c a a 'a 0n g c pp o o y v o 0 1. H N O O Y Y O o t ✓ O 0 0 0 0 a�U „ o 0 0 L 6 0 in w ,-1 0 0 to o u u w '0 '0 V V -1 • 'D Z N VD b '0 .. f� b t — re p. O V fro+ O O 0 ' 0 A 0 0 ti O a O u O oa N a v+ w 7 0 .2 o c a d V a oN L Y se = 6 t4-1 o r g d C bp O O Ti O • cu O ` M ea V O E O o> x x N i en 0 i U N 0' I ao . 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' i PERMIT NUMBER j � ✓ 2 • Assessor's Parcel ;iT3t ,.;- t11K..p please print or type DATE O e TO BE FILLED OUT BY APPLICANT PLOT PLAN ADDRESS pj•i•j cR Z..IeQ SStl I (0 Ti(egz. 1 NOTE: Show easements, property line dimensior SUBDIVISION pladt all other structures, specify north, and stre( FILING 1 LOT N BLOCK H _ name. For odd shaped lots, or if space is a 7'AX SCHEDULE N too small, provide separate plot plan. LEGAL (SEC /TW.V /RNG) 11 OF BUILDINGS NOW ON PARCEL w ( NAME L ARO j q f pi t/E c /f/li.n a',.JS USE OF BUILDINGS NOW ON PARCEL MAILING ADD ESS Oi Cat' 4(0 '6 CITY SJLT eat 8!'5 PHONE 303`5'7(0'21/6 Wile ' WV( +4.1 IsLii /&6, / ` Pc, t ekell NAME �f/ oaf�[L r./ �f , v a ADDR F.SS CITY / ° 4 (� o,/ ,a 2/ ine r ..i1/24.1-0-a. J a Li Ce L /N-' a NAME J4 fil ,pu4NN' /1100A-e B //1100A-e 1/0/4,56 £5 Q- n.444 & y.e OD,4 l'4.Q ' '6 ADDRESS „I4y7 h996wer b FJ SO in.) g CITY / l G,enN Su ,✓c� ,p co g15�s 7-174 eC4 . CC /9 n 72 12k � F. 'PHON t °ZONE ay3 y/oO LICENSE 1 W Kt 7(ag d9 a lecAoerna ' CLASS OF NORK T 11,4J ottail l 9 cfl' .•JEW fre ALTERATION ADDITION .l DEMOLISH REPAIR MOVE d/ / � / '" ui! / S q 19 , !g MOBILE HOME (make /model) SR y /./NF 14- 370 y / d•11414ry� (/ s.F. of BUILDING / S. 1'. OF LOT l` JI / °Q Or FLOORS / HEIGHT re, , 9 7 s- k OF FAMILY UNITS / /J OF BEDROOMS 3 !, Y „t) X ` 3°2 S INTENDED USE OF BUILDING /�pM� • _ , � J.b""'AJA �, _ GARAGE: SINGLE BBL CAR ORT: SIN.;LE DM. _ _ _ _ FRONT PROPERTY LINE FIREPLACE DOCUMENTS ATTACHED STREET NAME /ROAD NUMBER WATER SUPPLY _ -Q • -9 S L _ 2 CHECK IF CORNER LOT DRIVEWAY PERMIT DESCRIPTION OF WORK PLANNED SITE PLAN BUILDING PLANS SANITARY SEWER CLEARANCE • 1 I hereby acknowledge that I have read this ON SITE SEWAGE DISPOSAL PERMI application and the above is correct and I OTHER DOCUMENTS (specify) *CO6 /f1O0 agree to comply with all county ordinances THIS veil' IS AA/Wen TA/end one roar and state laws re•ulating building constructi( Iceceter. OwNte- /I _TO Pnvvsn /i / Sire PR 4r WofCrP it ass ens ro nu,. _ , ,.I NRS. P 1.4 rrn e Two fiCeRaort,t TNnC SIGNATURE SI2/COF tad' Feast se Vt4eFf7i b E USE ONLY VALUATION v it? nouns Ho nee - +� t 00• FLOOD HAZARD PERMIT FEE $ PLAN CHECK FEE $ CERTIFIED BLDG ELEVATION TOTAL FEE $ SCHOOL IMPACT FEE $ SPECIAL CONDITIONS DATE PERMIT ISSUED ZONING DISTRICT PROBLEMS WITH PERMIT TYPE OF OCCUPANCY ti FL movie (moo no TYPE OF CONSTRUCTION ADDITIONAL INFORMATION NEEDED S.F. OF BUILDING S.F. OF LOT MAX. HEIGHT ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYO! SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER REAR RIGHT LEFT OFF STREET PARKING SPACES REQUIRED as /AV All : ■ AL APPROVED: /W � .•Z , ^ / APPROVED: �t ` q � ,. DU DE'ART. DATE PLANNING DEPARTMENT DATE 1 No. 5234 GARFIELD COUNTY BUILDS G, SANITA77ONand PLANNING DEPARTMENT 109 8th Street Suitt 303 Glenwood Spring., Colorado 81601 (303) 945 -8212 lobnaarn. 0133 County Road 266, Silt NrturcorWork Building Permit UwofDulidinr Replace Trailer Home Ownv Tarry h Heather Meadows (Darlene Sorensen) Contractor Jack McLaughlin Mobile Homes Amount of Permit 8 100.00 p August 2, 1994 Set Up Fee: 100.00 S. Archuleta Clerk • INSPECTION WILL N0t tsE MADE UNLESS THIS CARD IS P1$ ED ON THE JOB 24 HOURS NOTICE REk ,ED FOR INSPECTIONS �UILDIi43 PERMIT Q A( COUNTY, COLORADO Date Issued ..... . Q a..Zoned Area Permit No 3 Y Y 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 const uction of the above described structure, the per it may then be revoked by notice from minty , p B i f ecttor ahcVIMMEDI Y NULL AND VOID, Use ketQ _ l Q ! i re x, 7tfl Nee Address or L7`gal Description On ✓ C.R. �4 4 .S 7 • OwnerLarr (flea e ow S Contractor Q c'k (1l 3 rel I a t Setbacks Front Side Side Rear This Card Must Be Posted So It Is Plainly Visible From the Street Until Final Inspection. INSPECTION RECORD Zoning Roof Covering Electric - Final (In STATE inspector) Footing Foundation Plumbing- Underground Gas Piping Heating Ventilation Frame Insulation Plumbing -Rough Drywall Electric -Rough (bc STATE inspector) _ Final g- ^G - q'-i zeci, ALL LISTED ITEMS MUST BE INSPECTED AND APPROVED BEFORE COVERING — WHETHER INTERIOR OR EXTERIOR, UNDERGROUND OR ABOVE GROUND. THIS PERMIT IS NOT TRANSFERABLE Phone 945 - 8212 109 8th Street, County Courthouse, Glenwood Springs, Colo. APP V D DO NOT DESTROY'' CARD Date p la t Bv rn1 = 14191 '_� ma ruder peptic Service. 0787 Odin Drivo sutt, 01652 —V mumwkit fit 1 i• �� e •' c S.' . i ! (. .r Customer's Order No. Phone Sold To Dot s199•� Address l C se? Y/65--7 en' Safteallal Waal! stanneama sammura mi la ®� ® OV1y returned TOTAL claims and 1 ^ AU. goods MUST a acc ponied by this bill. 5 4 9 4 Reed b t • `m wax, °r snecn — u ee ueepysu PASTA row sons July 22, 1994 To Whom it may concern; We, Larry and Heather Meadows, are the owners of the property located at 0133 CR 266, Silt, CO, and we do hereby give our permission for our tenants, Gary W. and Darlene S. Sorensen to remove their current mobile home and replace it with a new mobile home on August 18 and 19, 1994. They have our permission to apply for the building permit from Garfield County for the moving of these homes. Signature: 455674 at /"e.„08 Signature: ��L��' V /fl: - --