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/ GARFIELD C OUNTY BUILDING AND SANITATION DEPART NT Permit N2 3 2 F 9 x e
• A ssessor's Parcel No.
t r 109 8th Street Suite 303 )
Glenwood Springs, Colorado 81801 t
j = Phone (903) 945 -8212
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p This does not constitute
i 1 INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. •
Name
r PROPERTY r
P o el
t ; Owner g1 L vw' , 7a a ,
/ 1 � C 0 (1 cp P � �( ,{' UJ 4 l i () Phone ages p Co Q ( /S -
's 15� r � V f rese Address a � a V`_'
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I, { System Location O6 ! 6 ' , ( A ws+ ban K Ad . (CJPA\V3 boa 5(Rf NC. (.n Ui6Di t .
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I t Legal Description of Assessor's Parcel No. r 1
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t, t A C /-! e }{ A 1'4 ben- £3 E D — S.x'V ►u i t s
SYSTEM DESIGN v ✓ 'T A C AJ C/-/ F - S c: _3x v 1 .1
t
+ g Septic T k Ca city (gallon) Other 10/ C C 6- S "+
RR I 2v 1 3 - 7 a. CKA/-AOct 1.5t 0 = SO 1
+ 6 Percolation Rate (mutes /inch) Number of Bedrooms (or other) y T/t F,�cN 1 2 // x
4. dt
Required Absorption Area - See Attached
y
t ' Special Setback Requirements: 1 ,
'f
' . Date �' ' I ns p ect or / ' M U _ t i
d FINAL SYSTEM INSPECTION AND APPROVAL (as installed) f ,
# tl Call for Inspection (24 hours notice) Before Covering Installation
1 1) '
D {
System Installer E. I E1 �/ 7 CA e n/ 3 C" S M s F
s i
r Septic Tank Capacity -- - { .; ;< C X (S T t r G. ` t
Septic Tank Manufacturer or Trade Name _ t 1
•
Septic Tank Access within 8" of surface __ i
Absorption Area S 0 v N ( 1 S l IV 4 a c ( S /t 0i- S ®f /0 '.,
a
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q r Absorption Area Type and /or Manufacturer or-Trade Name 1 N F . L T r1. - t 0 K s a G
P Adequate compliance with County and State regulations/requirements - ), i
S ,. L
Other q q !7 - ` x
' r Date. 1 (-'� (' ( / Inspector (a �( " -. )
• 1 / RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE '
a t
7 *CONDITIONS: #
i 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Syste Chapter I,
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- t
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a
, i
requirement of the permit and cause for both legal action and revocation of the permit.
3 . Any person who consiructa, alters, orinstalls en individual sewage disposal system inamanner which involvesaknowing and material
i variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 8 1. t 1.
months In jail or both).
.1. White - APPLICANT Yellow - DEPARTMENT
• INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER 1)0.-u ..
ADDRESS a`{ 's- t uu 1- tak , P -Oe PHONE c /o t • •
c1 v-0 /9K S- 7y , •r' rnr
CONTRACTOR tit —
ADDRESS �., V i C o
D... ___ PHONE %7(
(A D
PERMIT REQUEST FOR (>').NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
ekt2 Q4 Ce aCLS.A • t cc act - k.s -12.d.
Attach separate sheets or report showing entire area with respect to surround areas, topography of area, habitable
building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
( QF PROPOSED FACILITY:
Near what City of Town s- <) � r 7 � � Size of Lot ' °I (� aM a � & f )
Legal Description or Address Co C t o . �}?d_T7E v ! i.— k. '
WASTES TYPE (X DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE______
Number of Bedrooms _. __. Number of Persons g.ct.A. l Cpl,
(D Garbage Grinder ( )1-Automatic Washer () Dishwasher
SOURCE AND TYPE OF WATER SUPPLY ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System? O r - • '
A site plan is repaired to be submitted that indicates the fofiowine 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.
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
2
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED.
(Y)-- SEPTIC TANK re ) AERATION PLANT ( ) VAULT
( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE
( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE
FINAL DISPOSAL BY:
()S ABSORPTION TRENCH, BED OR PIT -L k ( ) EVAPOTRANSPIRATION
( ) UNDERGROUND DISPERSAL ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER - DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?_
PERCOLATION TEST RESULTS: (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 deenud necessary to insure compliance with rules and regulations made,
infomwtion 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. 1 fiuther understand that any
fahification 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.
Ski 4111. -i Date / C7 - o`b —C7
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
R- &C-L-
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Location of 0676 Westbank Rd, Glenwood Springs
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Copyright 0 1988-1997, Mlaosort Corporation and/or as suppliers. All tights reserved. Please visit our web site at http: //maps.epedia,00m. Page 1
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Garfield County - Full Detail
Schedule Number: 10059 Parcel Number: 2395 -02-2 -02 -022
Owner Name: MCALLISTER, DAVID S. & JOY ANNE Property Address: 676 WESTBANK RD
Mailing Address: 676 WESTBANK RD Mailing City: GLENWOOD SPOS
Mailing State: CO Mailing Zip: 81601 -9378
Land Calculations
Land Description Units Unit Type Lot Remark
SINGLE FAM.RES: LAND 8.5 U 1.01 ACRES GOLF COURSE
Building Information
Improvement Type Style Exterior Wall 1 Exterior Wall 2 Roof Cover Heat Fuel
SINGLE FAM 1 WD SIDING NONE CEDAR SHAK ELECTRIC
Heat Type Structural Frame Baths Bedrooms Actual Year Built Exterior Wall 1 %
ELEC BS BD WOOD FRAME 3.0 3 1978 100
Exterior Wall 2
0
Sub Area Actual Area Heated Area
1 STORY 616 616
1 STORY W/ BASEMENT 750 750
1 STORY 700 700
GARAGE, FINISHED, ATTACHED 560 0
PORCH, ENCLOSED, FINISHED 234 0
BASEMENT UNFINISHED 750 0
BASEMENT, FINISHED 730 750
TOTAL 4360 2816
Lot Information
Block Lot Lot Thru Lot 2 Lot Remarks
22
Tract Information
Sec - Twnshp -Rng Tract Description
2-7-89
Sales Information
Book Page Sale Date Sale Price
730 265 03/14/1988 $131000
Features
Feature
F/P - AVG.
Feature
BALCONY
Feature
ENC PORCH
Feature
2-CAR GARO
10/21n 4:29 PM 1