Loading...
HomeMy WebLinkAboutApplication�R{ Garfield County 0 1% Community Development Department ma108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com TYPE OF CONSTRUCTION ❑ Commercial/Multi-Family BUILDING PERMIT APPLICATION 0 Demolition ❑ Manufactured Home (Single or Multi -Level) ti Residential (SF, Duplex orTownhome) , ❑ Reroof INVOLVED PARTIES Property Owner: 0, r, rar .. rt r f`) P1--v-r1 r-, Phone: ( Mailing Address: Contractor: �nI-�l„ ,Mr,,, .�J� �`i,„,r Phone: ('7b )<Ir I --15t�cS Mailing Address: ? O S':Sf, (I C; � C�t.c'•C cC Architect: \/ft - Phone: (fir ) Mailing Address: Engineer: (-) 11(7 Ct rfr t ►. �=� rr. ,.� . Phone: (r' ()) lO0C-, • Mailing Address: _ '? r�')�,a r 1� 4 r `��;v ; 4r' n r\ Manufactured Home Installer: P' -J' Phone: ( Mailing Address: PROJECT NAME AND LOCATION Describe Work: , f I la vV Job Address:. ? r` I , C. 1t L i c. c.r./ o fl t,s r L (16C , C Assessor's Parcel Number: `.' c c: -C-. G 1-r1.Sub. J Lot Block Owner's Valuation of Work: $ f' C , C,(_. 0 • GO Property Size (5q. Ft. or Acres): /"+ , rip r- Sq. Ft. of Building: Height: # of Floors: Class of Work: O New 0 Alteration 0 Addition O Repair Garage: 0 Attached O Detached Septic: OWTS ❑ Move/Relocation O Community Type of Heat: O Natural Gas Propane Driveway Permit: 0 Exempt 0 Electric O Permit #: 0 Other 1f [NOTICE Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Application. Legal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for purposes of inspections by the Building Division. Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit, (3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access or a State Wastewater Discharge Permit. Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICATION 1 hereby certify that I have read this Application and that the information contained above is true and correct. I understand that the Building Division accepts the Application, along with the plans and specifications and other data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness of the submittals and approval of this Application, a Building Permit will be issued granting permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the Building Division. In consideration of the issuance of the Building Permit, I agree that 1 and my agents will comply with provisions of any federal, state or local law regulating the work and the Garfield County Building Code, OWTS regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law. I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1) requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law. Review of this Application, including submittals, and inspections of the work by the Building Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer, engineer and/ or builder. I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have provided the required information wh, h is correct and accurate to the best of my knowledge. F rt,i ci/ , We 6T - Property Owner Print and Sign 5io/r� Date {{ OFFICIAL USE ONLY Special Conditions: Adjusted Valuation: 3o 85(p Plan Check Fee: ic.io Permit Fee: 4'51.s Manu home Fee: Misc Fees: Total Fees:Fees 16.56. Paid: SS ' 14 Balance Due: I O. (e i BP No: 131AzE-- b OWTS No: tpising # gds' Setbacks: OCC gC- ff�1``77�� Const �} �. RCR Zoning: BUILDING / PLANNING . L 1 ' DIVISION : �'' 3-n-- 1p Signed Approval Date . {.41 WA/ 3 to Ito Gntfield County 1 �l=a��flaaa 1 Permit Number: /-(1-4•Building Engineered Foundation :� - Driveway Permit /4' 4- - Surveyed Site Plan PNS7z Septic Permit and Setbacks ljA UTFO 63,8.4'. N fit- Grade/ Topography 30% Attach Residential Plan Review List Subdivision Plat Notes 1u e Fire Department Review Valuation Determination/ Fees Red Line Plans/ Stamps/ Sticker A ch Conditions pplication Signed Pia, • eviewer to Sign Application /4#. J� Parcel/ Schedule No. � 4 . 40#Snowtoad Letter— Manu. Homes 'JrHSoils Report Planning/ Zoning roperty Line Setbacks — 5/ 7 )0/1--% 30 ft. Stream Setbacks yl - A. Flood Plain /It wilding Height Zoning Sign -Off A / � Road impact Fees n` rA Grade/ Topography 40% Kirit Planning Issues ' 1- Subdivision Plat cS�L General Comments: Ni c -1t.Poi Arim Taraperi 3 21) s. v► 7 41-'- 2t/9P Old -414.44L )3/9Frie 447-6 2223.E X30 04611.= 30, � s �� . • This does not constitute a building or use permit. GAR FIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945.7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT N? 845 Owner Edward E. Pearson System Location County Road 126 -- 4 )y-) Licensed Contractor ' Conditional Construction approval is hereby granted for a /00e) gallon �,. Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Parc rate of one inch in minutes requires a minimum of i1-1 sq ft of absorption area per bedroom. Therefore the no. of bedrooms x /1/ sq. ft. minimum requirement = a total of 123 sq. ft. of absorption area. May we suggest /2x 3(.0`x 5 `C7 G -,PD O f" / X. 2 /it f F>p r Inspector �. ��� !�/��tu •-✓[, Date FINAL APPROVAL OF SYSTEM: r No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system Is approved prior to covert- Eng over=Eng any part. dv vK d k eke Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. Proper materials an assembly. .e Inav w ! Trade n me f sept c tank or aerated treatmentunit. Adequate absorption (or dispersal) area. / 8 'K 24' . - .6-,//e 1 el , li " Adequate compliance with permit requirements. r 1 Adequate compliance with County and State regulations/requirements. --- Other Date /9/'/''o Inspector 44/t 174* -1-'1 RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE `CONDITION 1. All insta latlon must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuantto au- thority granted in 66.44-4, CRS 1963, amended 66.3.14, CRS 1963. 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 viola- tion of a requirement of the permit and cause for both legal action and revocation of the permit, 3. Section 1I1. 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in- volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class Petty Offense (5500.00 fine — 6 months in jail or both). Building Official — Permit White Copy Applicant — Green Copy aaa a as a.aaaaa�� Dept. — Pink Copy •adub aaaaa. wwaaaa Owner: VSC Page Two Fees Paid $ dD INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 57-3C) - 4-2,1v Hrd P feso A Mail Address: /)0- Bs /o 57 City: q/,rlwaJ $ ,sZi p: r/60 INFORMATION REGARDING PROJECTSUBMITTEDFOR REVIEW ('6. Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percola- tion test holes, soil profiles in test holes (see Page 3). /1 Location of Facility: County GARFIELD City or Town e.vivoud� S7r ,J¢S Legal Descriptionbi. it Sc 9 717 S P o r111ot Size ' /2, e "Icre 5 Phone :79.57 5-Z 78 . 2. No. of Bedrooms 3 Septic Tank Capacity /o0064c.. 3. Source of Domestic Water: Public (name): 4r Pr.•i. Private: Well Depth e'c shea'Other Aeration Unit Capacity Rs Depth to 1st ground water table 4. Is facility within boundaries of a city/town or sanitation district? ,llo . 5. Distance to nearest sewer system: ,s /.(,.e s Have you attempted to arrange a connection with the If rejected, what was the reason? 6. If R.P.F. tested, state rate of absorption in test holes shown on the location map, minutes per inch of drop in water level after holes have been soaked for 24 hours: system? in 7. Name, address, and telephone of R.P.E. who made sail absorption tests: 8. Name, address, and telephone of R.P.E. responsible for design of the system: 9. Express permission is hereby granted for the inspection of the above property by any member of the Garfield County Building & Sanitation Department and/or such persons as they may designate. Any withdrawal of this permission shall be in writing and receipt acknowledged by the County Building & Sanitation Department. 10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula- tions of Garfield County and I hereby agree to comply with all terms, conditions and requirements included therein. 2/(e0 Dat Signature o app icant (TO BE RETURNED TO BLDG. & SANI. DEPT.)