HomeMy WebLinkAboutMemo to Void PermitDe.. Garfield County
Community Development Department
108 8t" Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
ONSITE WASTEWATER
TREATMENT SYSTEM
(OWTS)
PERMIT APPLICATION
TYPE OF CONSTRUCTION
12:1 New Installation
WASTE TYPE
p Dwelling I 0 Transient Use
0 Other Describe
0 Alteration
1 0 Repair
r❑ Comm./Industrial 1 0 Non -Domestic
INVOLVED PARTIES
IProperty Owner:
Mailing Address: la
Email Address: Jnr,
Contractor:
Mailing Address: j
Email Address:
Engineer:
Mailing Address:
Email Address:
PROJECT NAME AND Li -FS
Job Address: I F"f'.l�
Assessor's Parcel NumI
Building or Service Type
Distance to Nearest Cor ) i71: S P.c, 6
Was an effort made to connect to the Community Sewer System: 4-c. cp r-
• iso )8 - Z)e)e5
(6
1.0_)8'1A - J n0?7
Type of OWTS
)
Lot Block
_ Garbage Disposal(Y/N) IV
II Septic Tank I ❑ Aeration Plant 0 Vault 1 0 Vault Privy
0 Composting Toilet
O Recycling, Potable Use 0 Recycling 0 Pit Privy 0 Incineration Toilet
O Chemical Toilet 0 Other
Ground Conditions
Depth to In Ground water table Qop-1-.1Percent Ground Slope (°r)
Final Disposal by la Absorption trench, Bed or Pit 1 0 Underground Dispersal 0 Above Ground Dispersal
❑ Evapotranspiration -1-13 Wastewater Pond f 0 Sand Filter
❑ Other
Water Source & Type I$ Well 0 Spring 0 Stream or Creek 0 Cistern
O Community Water System Name
Effluent Will Effluent be discharged directly into waters of the State? 0 Yes v No