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Home My WebLink AboutApplication-PermitGARFIELD COUNTY DEPARTMENT OF rIVIRONMINTAL HEALTH 2011i Blake Avenue Glenwood Springs, Colorado 81601 'yatem,Location tea- /� ,� 3 Contractor wrwrwwrr.r•w I. Construction approvals glans and location are hereby approved. 47447 II et. Pere. rate inches in minutes* /"f' s . ft. oL' abaarption area per bedroom. _...r..rr.,- 2.y 2 349 s' . feet minimm re' rrrrrwrwrrrw.r+rw•ww...+..r..f r. '2. guirement. 1 suggest wMrrrrnw�rwr.r.wrw.rw �rrr Date 7 7 Impactor f 2. Final approval of systems No system shall be deemed to bei in compliance with the Sewage Disposal Laws until the assemb%ed system is approved prior to covering any part. Ly,...L ejlely tank cleanout Kith garb seal +r.�nw..r.•.. +�w�r.r.Marrrrrr,r.n..r.. Pro r muteriaie and assemb + Ade' uate absar im.1 art a w Ade' ate concxete� cover �dr� wells only wrrr.rrwrsrw.w� rrM.wrrr ri r. w r_ r ri r - rr� Covenants ei ned Date /V 73 Inspector ter.... ** Retain with permit records at construction site. r COLORADO nr,'PARTP !:NT OF HEALTH 14ater Pollution Control Division 14210 East llth. Avenue Denver, Colorado 80220 Ai -PLICATION FOR AkPROVAL OF LOCATION FOR MIX TANK SYSTEMS w Applicant (Owner):&lp� Hail Address= City: � �� inn in.rr A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: one: Attach separate sheets or report showing entire area with ;respect to surround- ing areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, soil profiles in test holes. . 1. Location of Facility: County d6e City or Town: 4/414 E _ Legal Description X L K 1 L e2r ...-..,,_,,,...,,.,. Lot y�. Type of area and facility . Number of persons served: Subdivision Other: Motel Restaurant Trailer Court+ 3. Source of domestic waters Public (name): Private: Well )( Depth2/1:. Other ^ Depth. to first ground water tables .... 4. Is facility within boundaries of City Sanitation District: If so names 5 • Distance to nearest sewer system: wo nr G`:,.,.,r....w...,. . r...r,rrrr r.. Have negotiations been attempted with owner to connects If rejected, give reason: 6. Rate of absorption in test holes in minutes per inch of drop in water level after holes have been soaked for 24 hours: 7. Name, address and telephone of person who made soil absorption tests: 8. Name, address and telephone of person responsible for design of the syetemt 9. Est. bid opening date: 3st• Completion Dater- Est. Project Costs_ Dater gnature o ' owner GARFIELD COUNTY ENVIROMENTtL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER R L , /9: 44 - LAMING ADDRESS PHONE LEGAL DESCRIPTIOaa OF PROPERTY ('WAS wipirworceAss SGA'. gL0a/c / .Ger .� [Tp 1` F'6'/.4 a 139 y 7 eoz,D. nvo LOCATION OF TEST HOLES (its e De/Vf Q,c- i* ieOPf_ T7 Three (3) test holes recuired per system ,, / Test Hole Depths (24" mini)---- 6 Diameter of Test Holes water Remaining after 24 Hour Soak f) /a Percolation Rate Each [tole Average Rate / ?' r?d ,Pfo•POOn? AleKSe. ",t/ 3S-6p/by /"/y 7• z2gy,� Dodson Engineered Products, Inc. F. 0. BOX 248 945-6346 Glenwood Springs, Colorado 81601 RICK A. DAHLINGER SALES REPRESENTATIVE I;ANE OF RLSPOIaSIBLE$ARTY RURUNNING TEST Y ./I�a�.SpykAhshye.,� e f �0�, .rbc, PHONE C/i ,(9 . c. DA's 2 6.%3 SIGNATURE TEST HOLE #Y TEST HOLE 02. --- ---- 1 TEST HOLE 03 Drop — Time Drop Time D. c_12 Ti.t ' •• /pie/ I - - /T///N - iy " .1-4/ /y" ',Iwo " i99�il1 �J " ///2-2/4). _....._ _._.. -- _ _ . _ _9' — — __ Percolation Rate Each [tole Average Rate / ?' r?d ,Pfo•POOn? AleKSe. ",t/ 3S-6p/by /"/y 7• z2gy,� Dodson Engineered Products, Inc. F. 0. BOX 248 945-6346 Glenwood Springs, Colorado 81601 RICK A. DAHLINGER SALES REPRESENTATIVE I;ANE OF RLSPOIaSIBLE$ARTY RURUNNING TEST Y ./I�a�.SpykAhshye.,� e f �0�, .rbc, PHONE C/i ,(9 . c. DA's 2 6.%3 SIGNATURE 4 w0 10) C0 V gi N W I. V1 \ p h O Q V 1 V Alc- kis kiti 0 1 w i 4 n, A_ V 'TTY a a i I.k eta 1 • N tl U' k• It h • ik N 11 tz k63 it O h k• ci V LL4 Ik A• u h q, Iex c. 0 1l UARFII LU GOLfl fY ENVi:ORNFIEi.riA)1. 11 EA Ti I 805 PITKIN AMINE GLENWOOD SPRINGS, COLORADO . APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT RECEIPT # 9ffs` OWNER s RESs t 7�S � l pJ.�__71�,,�� TELEPHONE CONTRACTOR s%�a-�• i�t-,,ems.« i ADDRESS :jteiTELEPHOIe S` SITE„6-e-LOCAT ONt N0. OF BEDROCKS: 3 • SIZE 01? LOT 1 Application for an individual sere disposal permit is hereby submitted° The individual sewage disposal system will be constructed in accordance with the regulations concerning individual sewage disposal systems within Garfield County° This application is valid for six (6) months from date signed. DATE: B 2 ? gIGNATURE: (/teX Perculation test resuite s , � 2 O Minutes per inchs Recommended minimum size of leaching systems Recommended minimal size of tanks DATE, PLOT PLAN 3�►1<iIT �tRXAN s r t{^+,14 • COLORADO DEPARTMENT OF HEALTH Water Pollution Control Division 4210 East llth Avenue Denver, Colorado 80220 APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS Applicant (Owner): Ifii91C 9 ArI Mal1 Address: 07.T5t Si> afetd C1ty: f}xhll/4& Phone: ?f 9/37 A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soli percolation test holes, soil profiles in test holes. 1. Location of Facility: County (.`mFrigid City or Town Q-A/wool ydehIS Legal Description J,07- i3/K / A,efriva/ Sub 1»ot Size: 3 S 2. Type of area and ffacility - Number of persons served: Subdivision 17 Motel Restaurant Trailer Court Other: 3. Source of domestic water: Public (name): Private: Well Depth (3S Other Depth to first ground water table 4. is facility within boundaries of City or Sanitation District: fin If so name: 5. Distance to nearest sewer system: /4/4-s Have negotiations been attempted with owner to connect: If rejected, give reason: 6. Rate of absorption In test holes in minutes per inch of drop in water level after holes have been soaked for 24 hours: 7. Name, address and telephone of person who made soil absorption tests: 8. Name, address and telephone of person responsible for design of the system: 9. Est. bid opening date: Date: 1.,5" /972 - Est. Completion Date: • Est. Protect Cost: Signature of Owner B. SIGNATURES FOR LOCAL GOVERNMENT OFFICIALS: The undersigned have reviewed the proposal for the location of the above-described septic tank system and RECOMMEND APPROVAL or DISAPPROVAL in the space provided below: DATE APPROVAL DISAPPROVAL Comments: 1.1 w►. v 1 f Signature for Local Health Department Signature for Mayor or City Manager Signature for County Commissioners Signature and Title Note: The applicant must obtain the comments and signature of at least one of the above. C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION: WP -1O (Rev. 5-70-100) COLORADO DEPARTMENT OF HEALTH Water Pollution Control Commission 4210 East llth Avenue Denver, Colorado 80220 DECLARATION OF COVENANTS KNOW ALL MEN BY THESE PRESENTS, THAT: WHEREAS, the COLORADO WATER POLLUTION COTROL COMMSION HAS approved the following described land, si u to in the)„.7-0.3 ] / ou/yy g of IGS/� and State of Colorado, to -w t: (describe ntire parceTto be served by septic tank) as a location fora septic tank, as defined by the Colorado Water Pollution Control Act. of 1966, as amended, for the treatment of domestic sewage on a temporary basis. NOW, THEREFORE, in consideration of the approval .of the above described land as a location for a septic tank, the undersigned, as the owner(s) of said land doetLdo hereby declare that the following covenants shall be and constitute cove- nant§ running with said land: 1. When the Colorado Water Pollution Control Commission determines that a community or municipal disposal system is available and can provide service to the above described land, the septic tank located upon said land will be abandoned and wastes from the described lands will be carried to the available community or municipal disposal system and the owner of the above described land shall bear the entire cost of constructing and installing any sewerage system necessary to carry such wastes to the available community or municipal disposal system. 2. If at any time hereafter, the septic tank shall adversely affect the quality of the waters of this State, the owner of the above described land shall use such other sewage disposal system as will maintain the quality of the waters of this State within the limits set by the applicable water quality standards adopted, from time to time, by the Colorado Water Pollution Control Commission. 3. This Declaration of Covenants shall be binding upon the undersigned. and the heirs, personal representatives, successors and assigns of the undersigned. (Continued on reverse side) 4, ,*.41, DECLARATION OF COVENANTS Page 2 IN WITNESS WHEREOF, the undersigned owner(s) has/have executed this Declaration of Covenants as of the /1' day of Apar , 19 71...- --OWNER(S)-- STATE OF COLORADO ss AND COUNTY OF • The foregoing Declaration of Covenants was executed before me this day of APpi!/j. , 1922 by # P g6 4 j 44 YivN as owner(s). Witness my hand and official seal. My commission expires: My Commission expires Sept, 25,1973 GGI4 e./Q,0•0), Notary Public Approved this Zi day of �,.� 197_ This approval subject to withdrawal if the foregoing s arat on o oven nts is not recorded within sixty (60) days of this App •val. COLORADO WATER POLLUTION NTROL COMMISSION By WP -30(1-71- 40) Technicetary