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Home My WebLink AboutApplication- Permitt �si4Act-civil GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 49I 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Nam .t, L' .r+ ''t1 System Location Present Address ())'-1, 1 S If - Mg -1 Dz., 3 LP Assessor's Parcel No. This does not constitute a building or use permit. PhoneL3G 'OS Legal Description of Assessor's Parcel No Q -1 -10 -2 - SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other Date Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION 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 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 system in a manner which involvesa knowing and material variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT GARFIELD COUNTY SEPTIC PERMIT APPLICATION 108 8th Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-8212 / Fax: 970-384-34701 Inspection Line: 970-384-5003 www earfietd-countv.cora 1 Perk Fee: Parcel No: (this formation is available at the assessors office 970-945-9134) a/ 7 / -7 / 61g-- -- 2 Building Permit ##: Job Address: (if an address has not been assigned, please provide Cr, Hwy or Street Name 8 City} or and legal description 1/97/at Cly ' ! f/ c 3q( 6i / f, 165 3 5-Cr6 c Lot Size: Lot No: Block No: Subd./ Exemption: t( a. t v'e$ 4 APPROVAL DATE Owner: (property owner} Birt e t. 4 6-e CoAds Mailing Address - 0 , Box mil S r )4- �'ut ` Ph: q7 0 s ~D3 s Alt Ph: Ca -�� i 5 Contractor: Mailing Address Ph: Alt Ph: 6 Engineer; Mailing Address Ph: Alt Ph: 7 PERMIT REQUEST FOR: ( ) New Installation ( ) Alteration (Repair 8 WASTE TYPE: (Dwelling•( )Transient Use ommercial or industrial ( )Non- Domestic w sten ( )Other - Describe V 1 ' ' ., / . ; 4,,4 • - - A a..' • ft,... ,t L ' 7 ,ate 10,41.32. 9 BUILDING OR SERVICE TYPE: Number of bedrooms ' Garbage Grinder ( )Yes )No 10 SOURCE &TYPE OF WATER SUPPLY: (4WELL ( )SPRING ( )STREAM OR CREEK ( )CISTERN If supplied by COMMUNITY WATER, give name of supplier: 11 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? 4 ow 4 YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN 12 GROUND CONDITIONS: Depth to 1St Ground Water Table Percent Ground Slope 13 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED: ( )Septic Tank ( }Aeration Plant ( )Vault ( )Vault Privy ( )Composting Toilet ( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy ( )Incineration Toilet ( )Chemical Toilet ( )Other- Describe _ 14 FINAL DISPOSAL BY: ( )Absorption trench, Bed or Pit ( }Underground ( )Wastewater pond ( )Other- Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter Describe 15 Will effluent be discharged directly into waters of the state? ( )YES 1\010 16 PERCOLATION TEST RESULT: (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 No.__ Minutes per inch in hole No.2 Minutes per inch in hole Name, address & telephone of RPE who made soil Name, address & telephone of RPE responsible absorption test: for design of the system: 17 Applicant acknowledges that the completeness of 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 V lon .r perjury as ole by lad. �� C 1,--Pc-e-, ` C 0 ter, OWNERS SIGN�i�TjRE DATE t /fit , ,5-` STAFF USE ONLY Permit Fee:. Perk Fee: Total fees: Building Permit ##: Septic Permit #: lig1 Issue Date: 5-Cr6 c Building & Planning Dept: APPROVAL DATE Parcel Detail Garfield County Assessor/Treasurer Parcel Detail Information AssessorlTreasurer Property Search 1 Assessor Subse uery 1 Assessor Sales Search Clerk & Recorder Reception Search Basic Building Characteristics 1 TaxmIformation Parcel Detail 1 Value Detail 1 Sales Detail 1 Residential/Commercial Improvement Detail Land Detail 1 Photographs 1 Mill Levy Revenues Detail Tax Area Account Number Parcel Number 12007 Mill Levy 023 R023139 217917200122 45.551 Owner Name and Mailing Address COLLINS, BRUCE R & BETTY J 350 WHITE HORSE DRIVE NEW CASTLE, CO 81647 Assessor's Parcel Description (Not to be used as a legal description) SECT,TWN,RNG:17-6-92 DESC: W 1072' OF NWNW, LYING 5 OF I-70 R.O.W. BK:0579 PG:0485 BK:0575 PG:0549 BK:0575 PG:0547 BK:1788 PG:995 RECPT:695878 13K:1640 PG:864 RECPT:663706 BK:1596 PG:229 RECPT:654079 BK:1531 PG:459 RECPT:639162 BK:1479 PG:563 RECPT:629183 BK:1318 PG:192 RECPT:595072 BK:1318 PG:190 RECPT:595071 BK:1318 PG:189 RECPT:595070 BK:0839 PG:0362 BK:0750 PG:0157 Location http://www.garcoact.com/assessor/parcel.asp?ParcelNumber=217917200122 9/5/2008 Parcel Detail 2008 Property Tax Valuation Information Physical Address: 4941 346 COUNTY RD SILT Land: Subdivision: 14,330 Improvements: Land Acres: 11.7 Total:) Land Sq Ft: 0 Section MODULAR MT Township Range 17 AVG PANEL 6 92 2008 Property Tax Valuation Information Additional Value Detai Most Recent Sale Sale Date: Sale Price: 6/6/2003 300,000 Additional Sales Detail Basic Building Characteristics Number of Residential Actual Value Assessed Value Land: 180,000 14,330 Improvements: 88,070 7,010 Total:) 268,070 21,3401 Additional Value Detai Most Recent Sale Sale Date: Sale Price: 6/6/2003 300,000 Additional Sales Detail Basic Building Characteristics Number of Residential 1 Buildings: 1 STORY: Number of Comm/Ind TOTAL HEATED AREA: Buildings: 1 k Residential Building Occurrence 1 Characteristics 1 t 1 STORY: 1,218 TOTAL HEATED AREA: 1,218 CODE: ABSTRACTIMPROVEMTS SINGLE FAM.RES- ARCHITECTURAL STYLE: PRE -HUD MOBILE HOME EXTERIOR WALL: MOD METAL ROOF COVER: MODULAR MT ROOF STRUCTURE: FLAT INTERIOR WALL: AVG PANEL http://www.garcoact.com/assessor/parcel.asp?ParcelNumber=217917200122 9/5/2008