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HomeMy WebLinkAboutApplicationGARHELD • Y Garfield County LOCommunity Development Department 108 81h Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.earfield-county.com ONSITE WASTEWATER TREATMENT SYSTEM (OWTS) PERMIT APPLICATION TYPE OF CONSTRUCTION ❑ New Installation WTE TYPE Dwelling i 0 Transient Use Other Describe 0 Alteration 0 Comm./Industrial 0 Non -Domestic INVOLVED PARTIES Property Owner: -�1)Q 1!/1 Phone: )-CLY Mailing Address: :3 M I ( ui 5 (20 ty l Contractor: Phone: ( ) Mailing Address: Engineer: Phone: ( ) Mailing Address: PROJECT NAME AND LOCATION —) Job Address: ?j'- j7 -e £ P i t 0,1,.) (40 gei&c 1 ' f Assessor's Parcel Number: 2 5C 5WCOsub.j�' Lot Block Building or Service Type: LLOMPT #Bedrooms: 5. Garbage Grinder Distance to Nearest Community Sewer System: I Was an effort made to connect to the Community Sewer System: life Type of OWTS V. 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 0 Chemical Toilet 0 Other Ground Conditions Depth to 1" Ground water table Percent Ground Slope Final Disposal by 0 Absorption trench, Bed or Pit A Underground Dispersal 0 Above Ground Dispersal ❑ Evapotranspiration 0 Wastewater Pond 0 Sand Filter 0 Other Water Source & Type "Awe!! 0 Spring 0 Stream or Creek 0 Cistern ❑ Community Water System Name Effluent Will Effluent be discharged directly into waters of the State? 0 Yes No f (N c)r2n. %E03 f=� � ,/312. CERTIFICATION Applicant acknowledges that the completeness o the application is conditional upon such further mandatory and additional test 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. 1 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 legal action for perjury as provided by law. I hereby acknowledge that I have read and understand the Notice and Certification above as well as have pro + ided the required/info mation which is correct and accurate to the bes of my nowledge. C_ Property Owner Print and Sign 25 OFFICIAL USE ONLY Special Conditions: � !>. iz,z /5° E4 ROL.24 Permit Fee: 3c. Di Perk Fee: , Total Fees: IS. DO Fees Paid: IS .00 Building Permit Septic Permit: Issue' Daatge:: lif Balance ue: BLDG DIV: e,-2�---2o1 + � APPROV• DATE ,.. . r to 100+1 43 IS- IS- ACCOUNT # R080363 PARCEL # 239503200024 TAX DISTRICT 008 REAL PROPERTY TAX NOTICE 2014 TAXES DUE IN 2015 KARLA J. BAGLEY TREASURER P.O. Box 1069 Glenwood Springs, CO 81602-1069 www.gartield-county.comltreasurer 6581 1./ Gan"ield County (970) 945-6382 TAX AUTHORITY MILL LEVY MILL LEVY CREDIT TAX AMOUNT VALUATION ACTUAL ASSESSED GARFIELD COUNTY 8.90500 0.00000 GARFIELD COUNTY - R&B 3.50000 0.00000 GARFIELD COUNTY - DHS 1.25000 0.00000 GLENWOOD & RURAL FIRE 10.58800 1.89000 COLO RIVER WATER CONS 0.25300 0.00000 WEST DIVIDE WATER CON 0.03900 0.00000 SCHOOL DISTRICT RE -1 42.14900 0.00000 COLORADO MTN COLLEGE 3.99700 0.00000 GARFIELD COUNTY PUB LIB 1.00000 0.00000 TOTAL NET LEVY --> 71 .68100 SB -No. 25- In absence of State Legislative Funding, GRAND TOTAL your School General fund Levy would have been 55.2 870 368.21 144.72 51.69 437.82 10.46 1.61 1742.86 165.28 41.35 2964.00 $2.964.00 NET TOTAL 519460 41350 NOTICES PROPERTY TAX EXEMPTIONS (CRS 39-3-203) A property tax exemption is available to senior citizens, surviving spouses of senior citizens, and disabled velerans. Senior Exemption Far an application. please contacl the Garfield County Assessor's Office at 970-945-9134 or jvelllsa©oartleld-county.carrt. Disabled_Veterans Exemption Application forms are available from the Colorado Division of Veterans Affairs at litto://vels,dmva.state.co.us.800(lor by calling 303-284-6077. PROPERTY TAX DEFERRALS (CRS 39-3.5-102) Active ir'litant For an applicati. please Contact the Gallie d County 7 easureand s Office al 970.945- 6382 PROPERTY DESCRIPTION (MAY BE ABBREVIATED) DO YOU OWE DELINQUENT TAXES? SECTION: 3 TOWNSHIP: 7 RANGE: 89 SUBDIVISION: CHELYN ACRES TRACT: 21 003792 117 COUNTY RD, 003792 FOUR MILE RD NO PAYMENT DUE DATE AMOUNT FIRST HALF FEB 28, 2015 $1,482.00 SECOND HALF JUN 15, 2015 $1,482.00 FULL PAYMENT APR 30, 2015 $2,964.00 THIS IS THE ONLY NOTICE THAT YOU WILL RECEIVE! SPRY, JAMES W III & NOL IA B 3792 COUNTY ROAD 117 GLENWOOD SPRINGS CO 81601-9583 RETAIN TOP PORTION FOR YOUR RECORDS Make Checks Payable To: GARFIELD COUNTY TREASURER IF YOUR TAXES ARE PAID BY A MORTGAGE COMPANY, DO NOT PAY THIS BILL.