HomeMy WebLinkAboutApplication195 w: 14th StreetRifle, CO 81650(970)625-5200
Garfield County
Public Ilea/th 2014 Blake Avenue Glenwood Springs, CO 81601(970)945-6614
OWTS PERMIT APPLICATION
TYPE OF SYSTEM CONSTRUCTION
D New Installation ID Alteration I D Repair
BUILDING USAGE TYPE
D Dwelling l D Transient Use ID Comm./lndustrial I D Non-Domestic
.IB Other Describe -+1 i! 1v1 ,t·n .IP 1/ 1 -1/ -�, �·
L� .----------------�---------·----------INVOLVED PARTIES , (:)J:.LL •. _� __ , Property owner:' · rfJby z '&£./ le,, Off,x;p/KV'-Ph-on-•:· 1ff1.r:Zi 87'1-Yo z t,;
Malling Address: S '8'0 .Je, ClH.)f?I, <=, t J:['NW tJ(){> , OJ Wfao/
EmallAddress: C.l�-n?4�t1tta,'f, Cc>tn •
·Contractor: Sfj,f� Phone: "fl2fl._)37f-'4:D 2. 6MailingAddress: I,( G.4,t,e,?; 4£ dfhW,e., H ./'29-t./& 2. 7,;+ ,,.,ii .. -- � .... I/ - . Email Address: i...; 'i, / A J � ,,u,,,,
Englneer:; _________________ Phone: 1,..._ __ 1.__ ____ _
Malling Address: ________________________ _
Email Address: _________________________ _
PROJECT LOCATION AND DESCRIPTION Job Address: C <:rr. I ii? 7 -
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______ _,_Assess ot's.�a,cel-;,umber::Z. m 1,:: q . Sub • ot Bloc,'1<-'---,--+-------+
Building or Service Type: • .,..06 jff #Bedrooms: 2. Garbage Dlsposa-l(Y/N)J{__
Distance to Nearest Community Sewer System: 7 11,t I /:4-5 C.lfW\..'( 0 O'\. �I<:...�
Was an effort made to connect to the Community Sewer System: -'t/_,,__0=---------
Potable Water Source lil"Well l D Spring I D Stream or Creek I □ Cistern
& Type D Community Water System Name _______________ _
Garfield County Public Health Department-working to promote health and prevent disease