HomeMy WebLinkAboutApplication-PermitProject Address
Garfield County
Building & Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81801 -
Phone: (970)945-8212 Fax: (970)384-3470
8630 CR 301 RD
DEBEQUE, CO
Owner Information
Danny Burchfield
Parcel No.
217532400061
Address
Subdivision
8630 CR 301
Parachute CO 81635
Issue Date: 7/28/2011
Section
Phone
970-285-6835
Expires: 01/24/2012
Township
Cell
Range
Contractor(s)
Phone
Primary Contractor
Danny Burchfield
(970)274-0606
Yes
Proposed Construction / Details
Single family dwelling on partial unfinished basement with covered
decks/patios on old home site.
FEES DUE
Fee Amount,'
Plan Check Fee $1,097.30
Residential Building Fee $1,688.15
Total: $2,785.45
FEES PAID
Valuation:
Total Sq Feet:
$ 223,238.40
1320
Inv Total Paytype ... Amt Paid Amt Due
Inv # BLRE-7-11-21239
$ 2,785.45 Check # 261
Check # 266
$1,009.94
$1,775.51
$ 0.00
Required inspections:
For Inspections call : 1(888)868-5306
Inspection
IVR
See Permit Record
Building Department
Copy
Thursday, July 28, 2011 2
108 8th Street, Suite 401, Glenwood Springs, CO 81601
Ph:970-945-8212 Fx:970-384-3440 Inspection Line: 888-868-5306
www.garfield-county.com
BUILDING PERMIT APPLICATION
R 2,
1
Parcel No: (this information is available at the assessors office 970-945-9134)
21A'5— 5�-oO -� DCo 1
Lot No: Block No: Subd./ Exemption: /
aA-tlt-now miP; & RPJ F: 9+T�. r sit/�
2
Job Address: (if an address has not been assigned, please provide CR, HWYor Street Name & ity) or and legal description
53(40 ti)11u14114 Inky 46 j?AfMt-4.k i C
3
Owner: (property owner)
got -441,4.--f Ca-C.W, A nt Ni`-(
Mailing AddrSss:
Bee -5e) e.g. 501
Ph:
V34-66130
Alt Ph:
4
Contractor:
geeK co moi:
Mailing Address:
1701 Oa l r4 ar2., s r c -r
Ph:
f 7 G -4;4 C(o
Alt Ph:
t.14;- n 44
5
Manufactured home installer:
Mailing Address:
Ph:
Lic #:
6
Architect:
V. L 1.—e
Mailing Address:
i a" d p i rJ 71R-, c r e, i
Ph:
27s-- Z3
Alt Ph:
7
Engineer:
Mailing Address:
Ph:
Alt Ph:
8
Sq. Ft. of Building:
1��0
Sq. Ft. or Acres of Lot:
�7 Zc
Height:t
No. of Floors:
04 4 ECen
9
Use of Building:
2P,esidential DCommercial DOther
Class of Work:
.Iiew ❑Alteration DAddition DRepair ❑Demo DMove
10
Describe Work:
14C ito me c tJ ot.--ti 1-Ears 4 T
11
Garage: u0hiV
❑Attached ❑Detached
Septic: GjCIsTIe.4Ct
IISDS ❑Community
Type of Heat:
❑Nat. Gas opane ❑Electric DOther
12
Driveway Permit:
Pr',1\le t, CCisZir-fC-7
Owners valuation of Work:
e(?.DOt con
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.
Le2a1 Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for purposes of inspections by the Building Department.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County ISDS 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
I hereby certify that 1 have read this Application and that the information contained above is true and correct. I understand that the Building Department 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 Pennit will be issued granting permission to me, as Owner, to construct the structure(s) and facilities detailed on
the submittals reviewed by the Building Department.
In consideration of the issuance of the Building Permit,1 agree that I and my agents will comply with provisions of any federal, state or local law regulating the work and the Garfield County Building
Code, ISDS 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 Department to enter the property, described above, to inspect the work. 1 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 Department do not constitute an acceptance of responsibility or liability by the County of errors, omissiors
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 HA ' READ A II UNDERSTAND THE NOTICE & CERTIFICATION ABOVE:
1tei3 til
,_QWNFL,RS SIGNATURE. DATE
C49161 15‘004g
STAFF USE ONLY
•
Special Conditions:
Adjusted Valuation:
ZZ 3, Z 38. l0
Plan Check Fee:
% 0 9 7 3 d
Permit Fee:
16 8 g, /,"
Manu home Fee:
.�-
Misc Fees:
.___--_
Total Fees:
z�7Bt�, ��
Fees Paid:
OO q. q �{
Balance Due:
17'75.51
BP No & Issue Date:
ISDS No & Issued Date:
131.2E -D,015
Setbacks:
Z
P S, g. Zr , S !D
OCC Group:
,�'RC
Const Type:--
�'g.L.
Zoning:
R
APP VAL DATE
;ROYAL DATE!�
VALUATION FEE DETERMINATION
Applicant Danny Burchfield Subdivision N/A
Address 8630 CR 301 Parachute Lot/Block N/A
Date 7/27/2011 Contractor Becker Construction
Finished (Livable Area):
Main 1320 sq.ft
Upper sq.ft
Lower 960 sq,ft
Other spit X $74.68
Total Square Feet 2280 sq.ft
Total Valuation
Basement:
Unfinished 360 sq.ftX $41.00
Conversion of Unfinished to Finished sq.ftX $33.68
Other sq.ft X
Total Valuation
Garage/Storage (wood framed) sq.ftX $18.00
Conversion of garage to finished living sq.ft X $56.68
Carport sq.ftX $12.00
Other sq.ft X
Total Valuation
Crawl Space
Total Valuation
sq,ft X $9.00
Decks/ Patios/Porches
Covered 1592 sq.ft X $24.00
open sq.ftX $12.00
Other sq.ft X
Total Valuation
Type of Construction:
Occupancy:
Total Valuation
Commercial
sfX
sf X
sf X
sf X
sf X
sf X
170,270.40
14,760.00
0.00
0.00
38,208.00
0.00
Total Valuation 223,238.40
Applicant:
Job Address:
Subd- Lot/block:
FEE ESTIMATE
FOR SIF STICK BUILT HOMES
(ALL FEES ARE ESTIMATES UNTIL FINAL PLANS ARE REVIEWED)
g� �a cR. 50 1 t PAP. -Az- 4 \I -T-6
1.-1A / KAZ
FINISHED LIVING SPACE:
UNFINISHED BASEMENT:
CRAWL SPACE:
GARAGE:
Z i vac) sf X 74.68=
3620 sf X 41.00=
sf X 9.00=
sf X 18.00=
UNCOVERED PATIO/DECK:
COVERED PATIO/DECK: / Z S sf X 24.00=
MISC:
sf X 12.00=
MISC:
l�Z3.4-t)
t4,1400.0b
0
b —
TOTAL VALUATION: Zl 4- 5"cj 8 , 40
THIS SECTION WILL BE DETERMEND BY GARFIELD COUNTY BUILDING & PLANNING
PLAN REVIEW FEE:
PERMIT FEE:
TOTAL:
SEPTIC=
PERMIT:
PERC:
Building Pian Review
Description of Work: New home on old home site.
13in #:
Location Address: 8630 CR 301 RD
DEBEQUE, CO
General Information
Case Manager: David Bartholomew
Plan Case Number: BLDG -7-11-6940
Parcel: 217532400061
Application Date: 07/22/2011
MOM CM
Owner: Danny Burchfield
Applicant: Danny Burchfield
Applicant Phone: 970-285-6835 Email:
Building PlanninglZoninq
Engineered Foundation / Property Line Setbacks
/ Driveway Permit / 30ft Stream Setbacks
4) Surveyed Site Plan / Flood Plain
Septic Permit and Setbacks =Building height
Grade/Topography 30% zoning Sign -off
Attach Residential Plan Review List NX4 Road Impact Fees
7 /
Minimum Application Questionnare HOA/DRC Approval
0 Subdivision Plat Notes / Grade/Topography 40%
-`'EI Fire Department Review lanning Issues
/ Valuation Determination/Fees Subdivision Plat
7 Red Line Plans/Stamps/Sticker General Comments:
Attach Conditions
1
_Application Signed
Plan Reviewer To Sign Application
Parcel/Schedule No.
®~//lt 40# Snowload Letter - Manu. Homes
PP Soils Report
1
David Bartholomew
From: David Bartholomew
Sent: Wednesday, August 03, 2011 2:37 PM
To: 'Dan Becker'
Cc: Matt Provost; Jim Wilson.
Subject: RE: Changes for Burchfield permit, design
Dan,
Got it. I'll print and insert these changes into the permit file.
As stated, install underlayment and asphalt shingles per manufacturer's specifications. Also, have the ICF
manufacturer's specifications onsite for foundation inspection. Foam plastics must comply with IRC Section 316. See #
23 in your plan attachments for thermal barrier requirements.
Feel free to call with any questions or concerns.
Thanks,
Dave
David Bartholomew, Plans Examiner
Garfield County Building & Planning
108 8th Street, Suite 401
Glenwood Springs, CO 81601
Office: 970-945-8212
From: Dan Becker fmailto:dbeckerOwillowwisp.neti
Sent: Wednesday, August 03, 2011 10:36 AM
To: David Bartholomew
Subject: FW: Changes for Burchfield permit, design
Dave,
As per our phone conversation please note the following changes to the construction of the Burchfield residence at 8630
County Road 301, Parachute:
■ The roof pitch will change to 3.5 or 4 to 12. Underlayment to be placed as per shingle manufacture
requirements.
• An ICF forming system, Reward Wall, will be used for the foundation wall forming. Horizontal rebar
placement will remain at 16"oc. Vertical rebar placement will change from 16"oc to 18"oc to accommodate
the block ties.
Thank you,
Dau. Decker
Decker COwStructG 2kt
9yD 275-2744 ce6l
S'66-516 DGe
1
GARFIELD COUNTY
Building & Planning Department
108 81h Street, Suite 401
Glenwood Springs, Colorado 81601
Telephone: 970.945.8212 Facsimile: 970.384.3470
www.garfield-countv.com
SINGLE FAMILY OR DUPLEX BUILDING PERMIT.
NOTE: In order to understand the scope of work intended and to expedite the issuance of a permit, it is
important that complete information be provided. Please review this document to determine if you have
adequate information to design your project and to facilitate a plan review.
SINGLE FAMILY OR DUPLEX BUILDING PERMIT APPLICATION CHECKLIST
This checklist is to be used with all single family dwelling construction.
APPLICATION FORM: Please make sure the following information is provided on the application.
Parcel number obtained from the County Assessor's Office. ---
Job
Job address (assigned physical address)
Legal Description: lot, block, filing, subdivision or tract, section, township and range.
Owners name, mailing address, phone, fax, or cell.—
Contactors name, mailing address, phone, fax, or cell. -1
Architect/Engineer's name, mailing address, phone, fax or cell. -"
Building size, height, number of stories, lot size. —
Use of building (residential)
Class of Work (new, addition, alteration, repair, demo, move, other) —
Description of work. —
Type of heating (natural gas, propane, electric, other).—
Sewer system (Community or ISDS), also see other items below.—
Garage (attached or detached). .
Driveway permit (please see other items below) l
Valuation (labor and materials) see attached worksheet.
OTHER ITEMS:
=Mid
provide water
re it of c f + '• - -tter indicating that
(Required to submit building permit application).
per - • • ice std with the building permit application.
A separate electrical permit must be obtained from the State of Colorado Electrical Board.
Prior to submittal of a building permit, you are required to show proof of legal and adequate
7 access to the site. This may include proof of right to use a private easement, County Road &
Bridge permit, or Colorado Department of Highway permit, including a Notice to Proceed. The
County Road & Bridge Department can be reached at 970-625-8601.
11 If you anticipate excavating or grading prior to issuance of a building permit, you will be required
to obtain a separate grading permit.
1 you + ng to . iatiorr(HGA)it is your responsibility to obtain written
a oval,' -•uired.
Pravide-e. •' '' - • an •ons an. r ase Permi s associated with this property.
AMR' ellii r re trative Review.
'nim a in iraa�asi 20 feet long.
A olorado State Licensed Electrician and Plumber must perform installation and hook-ups,
unless the homeowner is performing the work.
BUILDING PLANS: Two (2) sets of plans must be submitted. Plans must be 18"x24" minimum size,
complete, identical, legible, and to scale. All plans will be checked at the counter for completeness. If any
of the required information is missing, the building permit application cannot be accepted.
SITE PLAN: Please make sure the following information is provided on the site plan.
Property address/legal description. -
North Arrow and Scale on each page. -
Show all property lines, building envelopes, flood plain, and easements.
Provide setback distances from boundaries, buildings, septic, well, and waterways.
Location and direction of the county or private road and driveway accessing the property.
Proposed and existing structures include sheds, barns, decks, patios, and any other buildings.
Existing and proposed grade, positive drainage around structure (to be contained on site).
Streams, rivers, creeks, springs, ponds and ditches.
Existing and proposed wells, septic tanks, leach fields, and other systems. (if applicable)
Retaining walls (engineer stamped detail required for walls over four (4) ft, measured from bottom
of footing to top of wall).
NOTE: Any site plan depicting the placement of any portion of the structure within fifty (50) feet of a
property line or not within an established building envelope shall be prepared, stamped, and signed by a
licensed surveyor. For structures to be built within a building envelope, provide a copy of the recorded
subdivision final plat with the proposed structure located in the building envelope.
ARCHITECTURAL PLANS: Please provide the following information on the architectural plans.
11 Minimum four (4) elevations (N,S,E,W) Indicate height of building measured from existing grade
to the midpoint between the ridge and eave of a gable or shed roof or to the top of a flat roof.
Floor plans for each level including dimensions and scale noted.
Clearly label each room or space (bedroom, bath, kitchen, closet, etc).
Show the location of the mechanical equipment.
Building cross sections with construction details.
Window sizes, types, and operation noted on the floor plans or elevations.
Specify roof slope/pitch, roof covering, and siding materials.
Stair and guard details specifying rise, run, height and spacing.
Attic, roof, and crawlspace ventilation details. Indicate size and location of ventilation openings.
Minimum insulation shown for walls, floors, roofs/ceilings, slabs, basements and crawlspaces.
Provide stove and fireplace make, model, EPA or Colorado Phase II Certification. Masonry
fireplaces shall be designed to the International Residential Code (IRC) requirements.
STRUCTURAL PLANS: Please provide the following information on the structural plans.
Design specifications to include roof and deck snow load, wind and seismic design, frost depth.
Foundation plan showing complete footing and foundation dimensions.
Footing and foundation details specifying reinforcement and referenced on plans.
Framing plans for each floor level and roof, All beams, columns, joists, rafters, and trusses
specified. Pre -manufactured structures require the engineers stamp, signature, and date.
Framing /connection details, braced wall lines, shear wall schedule, location and hold downs.
NOTE: If any required information is missing, delays in issuing the permit are to be expected. If
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The building department will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Septic or Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
hereby acknowledge I have read, understand, and will abide by the requirements of this
checklist.
c>0a,4
itz( [ze
Signature of Owner Date
Garfield County Building & Planning
108 8th Street, Suite 401
Glenwood Springs, CO 81601
Phone: 970-945-8212 Fax: 970-384-3470
www.garfield-cou ntv.com
CONDITIONS OF PERMIT
BLRE-7-11-2128
Danny Burchfield
8630 CR 301
Parachute, Colorado
1) VERIFY SEPTIC SYSTEM IS SIZED FOR TWO (2) BEDROOMS BY PUMPING TANK. PROVIDE
SEPTIC PUMPING COMPANY VERIFICATION PRIOR TO ROUGH PLUMBING INSPECTION.
ALTERATION OF SEPTIC SYSTEM REQUIRES A PERMIT.
2) CONTACT GARFIELD COUNTY ROAD AND BRIDGE DEPARTMENT TO VERIFY DRIVEWAY
PERMIT REQUIREMENTS OR EXEMPTION STATUS. PROVIDE VERIFICATION PRIOR TO
CERTIFICATE OF OCCUPANCY.
Garfield County
Building Requirements
Codes: 2009 IRC, IBC, IFGC, IMC, IPC, 2009 IECC.
Setbacks: Check subdivisions and zone district for setback requirements.
Snowload (measured at the roofl Not ground): 40 PSF up to 7000 ft. elevation ,%
50 PSF 7001-8000 ft. elevation
75 PSF 8001-9000 ft. elevation
100 PSF 9001-10000 ft. elevation
Seismic design category: B
Weathering probability for concrete: Severe
Termite infestation probability: None to slight.
Wind Speed: 90 mph
Decay probability: None
Wind Exposure: B or C (see section R301.2.1.4)
Frost Depth: 36 inches to 8000ft elevation. 42 inches 8001ft elevation and above.
Winter Design Temperature: Minus 2 to 7000ft.; minus 16 over 7000ft elevation.
Air Freezing Index: 2500° F -days to 7000ft.; over 7000ft. to be determined by Building Official
Ice Shield under-layment required.
Mean Annual Temp: Variable
Insulation: Windows/doors U=.35; Skylights U=.6; TBL 402.1.1, 2009 IECC.
Minimum R -Values:
• Ceilings/roofs R values are R-38 stick built structures. R38 log
construction and steel rafter construction
• Walls R values are R-20 wood frame. See Table 402.2.5 2009 IECC for
steel framing
• Floors R -values are R-30 or enough to fill cavity
• Basement wall R -values are R-10/13
• Slab perimeter R -values and depth is R-10/24 in.
• Crawl space wall R -value are R-10/13
Floors over vented crawlspaces must be insulated; R-30 or enough to fill the cavity. Vents shall
be located below the bottom of the floor joist per [RC, R-408.1. As an alternative to insulating
floors, crawlspace walls shall be permitted to be insulated when the space is not vented to the
outdoors and meets the requirements of IRC, R-408.3. Basement walls must be insulated to
frost depth: Common garage to house walls and ceiling -floors must have minimum R-20
insulation. Take precautions to protect plumbing in these areas.
Account
Account: E.024368
Location
Parcel Number 2175-324-00-061
Situs Address 301 COUNTY RD
City Debeque
ZipCode 81630
Tax Area 024 - 2HD-RF - 024
Legal Summary Section: 32 Township: 6
Range: 94 TR lN S1/2SE
Transfers
•Sale Price
$70 000
Owner Information Assessment History
Owner Name BURCHFIELD, DANNY
R & ANNIE R •
Owner Address 8630 COUNTY ROAD
301
PARACHUTE, CO 81635
Sale Date
08/04/2010
01/14/2010
02/02/200:7
10/07/2004
Tax History
Tax Year Taxes
*2011 $2,933.16
2010 $3,792.76
* Estimated
Images
• Photo
• GIS
• Doc Type
173
173
W
QCD
Actual (2011)
Primary Taxable
Tax Area: 024
Page 1 of 1
$224,270
$65,040
Mill Levy: 45.0980
Type Actual Assessed Acres SQFT Units
Land $224,270 $65,040 37.920 0.000 0.000
Book Page
B: 1929 P: 20
B: 1628 P: 997
https://actgarfield-county.com/assessor/taxweb/accountjsp?accountNum=R024368
7/22/2011
T Permit Card
Garfield County
Building and Planning Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
Phone: (970)945-8212
Fax: (970)384-3470
POST ON SITE .,.`.
PermitNO. BLREU71 1 1 -21 28
Issue Date: 7128/2011
AGREEMENT
In consideration of the issuance of the permit, the applicant hereby agrees to comply with ail laws and regulations related to
the zoning, location; construction and erection of the proposed structured for which this permit is granted, and further
agrees that if the above said regulations are not fully complied with in the zoning, location, erection and construction of the
above described structure, the permit may then be revoked by notice from the County Building department and
IMMEDIATELY BECOME NULL AND VOID,
Residential Building
Parcel #:217532400061
Owner's Name: Danny Burchfield
Job Address: 8630 CR 301 RD
DEBEQUE, CO
Contractor(s)
Phone
Primary Contractor
Danny Burchfield
(970)274-0606 Yes
Owner's Phone: 970-285-6835
Total Square Feet:
1320
Work Description: Single family dwelling on
partial unfinished basement with covered
decks/patios on old home site.
Inspection Scheduling Code
Foundation Walls
Drywall
Final
Misc
insulation
Grout
Mechanical
UG Plumbing
Rough Plumbing
Gas
E/tid,;c 710.
F Off!
ADDITIONAL INSPECTIONS MAY BE REQUIRED
POST THIS IN CONSPICUOUS PLACE WHEN CONSTRUCTION IS STARTED
For Inspections Call: 1-888-868-5306
6-1(
/216*-aj 3 04.2,4
4 (4 War- ft
4
Project Address
Garfield County
Building & Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81601 -
Phone (970)945-8212 Fax (970)384-3470
Parcel No.
Subdivision
Section
Township
Range
301 COUNTY RD
DEBEQUE, CO
Owner Information
217532400061
Address
Phone
Cell
Danny Burchfield
8630 CR 301
Parachute CO 81635
970-285-6835
Contractor(s)
Phone
Primary Contractor
Proposed Construction /'Details
Septic for STEN RWF 44-32
FEES DUE
Septic Fee - New
Total:
•
$73.00
$73.00
Valuation:
Total Sq Feet:
FEES PAID
$ 0.00
0
!aid
knv # SEPT -9-10-20507
$ 73.00 Check # 6321
$73.00
$ 0.00
C' oedefar/ - . 14,1-// 4 v_ a/e//pvi
Required Inspections:
For inspections ail ; 1(8B8)868-5306
inspection
IVR
See Permit Record
Building Department ,
Copy
Friday, September 10, 2010
2
GARFIELD COUNTY SEPTIC PERMIT APPLICATION
1088"Street, Suite401, Glenwood Springs, CO 81601
Phone: 970-945-8212 /Fax: 970-384-34701 Inspection Line: 970-384-5003
www. parfielet-county„corn
1
Fc -e:
Parcel No:(this information is available at the assessors office 970.945-9134)
2175-324-00-061
2
Septic Permit #:
kifig — CI — 1 0 — 11 4111
.fob Address: (If an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
RWF 44-32 See the attached plat for description.
3
A rROVAL'. PATE
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Piat
4
Owner (property owner)
Danny R. Burchfield
Mailing Address
8536 County Road 307
Parachute, CO 81635
Ph:
970-285-6835
Alt Ph:
Contractor:
Williams Production
MIT re,
PO Box 370, Parachute, CO
R1 B'e
Ph:
970-285-9377 ext 2288
At Ph:
6
Engineer.
NIA
Meiling Address
Ph:
Alt Ph:
Permit Reauest For: (X 1 New installation ( 1 Alteration (1 Repair
8
Waste Type: (X ) Dwelling ( ) Tranlent Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes
( ) Other- Describe
9
Building Or Service Type:
Number of Bedrooms: Garbage Grinder ( ) Yes (X )No
10
Source & Type of Water Supply: ( ) Well ( ) Spring ( ) Stream Or Creek ( ) Cistern
If supplied by COMMUNITY WATER, give name of supplier: Down Valley Septic and Waste
11
Distance to Nearest Community Sewer
Was there an effort to connect to the
System:
_NIA
community System? NIA
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12
Ground Conditions:
Depth to 1st Ground Water Table NIA Percent Ground Slope N/A
13
Type of Individual Sewage System (150S) Proposed:
( } Septic Tank ( Aeration Plant ( X) Vault ( } Vault Privy ( )Composting Toliei
( ) Recycling, Potable Use ( )Recycling, Other use ( ) Pit Privy ( )incineration Toilet ( ) Chemical Toilet
(X) Other Describe: Hauled to Down Valley Waste for their disposal
14
Final Disposal By:
( ) Absorption trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal ( ) Evapotranspiration ( ) Sand Fllte
( ) Wastewater pond i(X )Other -Describe Hauled to Down Valley Waste for their disposal
15
will effluent be discharged into waters of the state? ( )Yes (X )No
16
Percolation Test Result: (to be completed
Minutes per
by Registered Professional Engineer, If the
inch in hole No.1
In hole No.2
made soil absorption test: NEA
Engineer does the Percolation Test)
Minutes per Intl in
N/A
hole No.3
No.4
Minutes per Inch
Minutes per Inch In hole
Name, address & telephone of RPE who
Name, address & telephone of RPE responsible
for design of the system:N/A
17
Applicant acknowldges that the completeness of the application is conditional upon such
by the local health department to be made and furnished by the applicant or by the lees
and the issuance of the permit is subject to such terms and conditions as deemed necessary
information and reports submitted herewith and required to be submitted by the applicant
knowledge and belief and are designed to be relied on by local department of health
herin. l further understand that any fats ,1., .n or mtsreprensentalon may result in the
said - r. and .. al actie 1r :r t IT = provided by law.
further mandatiory and additional test end reports as may be required
I health department for purposed of the evaluation of the application;
to insure compliance with the rules and regulations made,
are or will be represented to be true and correct to the best of my
in evaluationg the same for purposes of lesuing the permit applied for
denial of the appfoation or revocation of any permit granted based upon
t. - IJ Bpd.
/ f Is 11191a�—,T1s
• • - - • nature: Sandra Hotard t i`' Date
'Pdd 1521°- •
STAFF USE ONLY
Permit Cl!P:Perk
- 7 cam
Fc -e:
Total fees:
-- O
Building Permit #:
Septic Permit #:
kifig — CI — 1 0 — 11 4111
Issue Dote;
9//0 1 (6,
A rROVAL'. PATE
rs
.,71e 2
0';o
RWF 44-32
Vault System Description
The site will temporarily office and house up to a maximum of four individu-
als during natural gas drilling activities and is expected to be completed in
one year or less. The individuals will occupy two individual trailer offices/
houses located on the well pad. Office/houses have Colorado Division of
Housing compliance tags.
One aboveground sewage holding tank with 4000 -gallon capacity on-site.
The Vault System is displayed in both of the pictures. Sewage flows esti-
mated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding
tank needs to be emptied approximately every 13 days (4000 gallons/
300 gallons per day). Wastewater vault is equipped with overflow alarm
device. Williams utilizes the services of a licensed contractor to removed
and haul the wasterwater to a state certified treatment/disposal facility.
One potable aboveground water tank of approximately 4000 gallons ca-
pacity on-site. Posted on the front of the Tank there is a Sign that states
"Potable Water Only". Potable water demand is estimated to be 300 gal-
lons/day (4 individuals x 75 gpcd). Required minimum fire suppression
demand is 2500 gallons. Total potable and fire suppression demand is
estimated to be 4000 gal-
lons.
Road access to the site is
maintained year round
through the services of pri-
vate road maintenance and
construction contractor.
.7.4:,'4%
1
Section 32
6S.,R.9.1 W
1
Property 1
Boundary NE #78
C 5.0'
Existing Stone Mounds
Possible Grave Site
-415'
' ' • 0
. e e
NE #7A
J ....
F1.0' e l
.1
Daylight Line
c:4 \
P ft
•,.'g
B N #0 I/
F 5.9'
c
E #8
C 10.3'
/7, Cut/Fill Line
ru
1
i'$ • 00'°'
1::::, ., • cra \-.
',.. PI % . • ,L..1) `'Z'i
,. . ... ,..0 \
.. ...
F1:5'.
'F4.3' \
,\
tv 2.7'
N06,°0814\9141'
100' \
SE ;18'
C19.1'
\ ,
Nr6 r.-
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C 14.
NW #58
F
BOLO
i. '' :,.?:•) , - ..'''. L......--- /
"NOTES:
1 Firoposed
1) USE EXCESS PIT MATERIAL TO
COMPLETE PAD SURFACE. f ! Access Riad
2) TOPSOIL VOLUME BASED ON 12* ! j i •
SOIL DEPTH.
3) Total Pad Disturbance = 6,10 ac,
SC.ALE:
DATE:
PLAT:
PROJECT.'
DFT:
SO'
2/4/09
2 of 9
VViiiiams 2030
cum
. ESTIMATED DIRT QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
•EXCESS
PAD
28359
20914
7600
-155(F)
PIT
7117
7117
TOTALS,
35476
20914
7600
6962
Construction Plan Prepared for:
Mem Williams Production, RMT
Burchfield RWF 44-32 - Plat 2
CONSTRUCTION LAYOUT
Itto
20p2
GRAPHIC SCALE RV FEET
1 Wag. 2oc0 tEET
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HIGHWAYS AND COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED
SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD) ±1,1 MILES TO THE INTERSECTION WITH COUNTY ROAD 348
(RULtSON PARACHUTE ROAD), PROCEED LEFT IN AN EASTERLY DIRECTION ±1.4 MILES TO THE INTERSECTION WITH COUNTY
ROAD 301 (MORRISANIA MESA ROAD), PROCEED RIGHT IN A SOUTHERLY DIRECTION ±0.6 MILES TO AN INTERSECTION WITH A
DIRT/GRAVEL ROAD, PROCEED LEFT IN A EASTERLY TO NORTHERLY DIRECTION ±0.4 MILES TO THE RWF 44-32 DRILL PAD
LOCATION, AS SHOWN HEREON,
REVISED: 2/27/10
.t Fri E xxfi�i { /FI
Construction Plan. Prepared for:
Intim& Williams Production, RMT
Burchfield RWF 44-32 - Plat 5
ACCESS ROAD MAP
• EntilliTilikailliNifiglideriClalligliAlli111111
Reception#: 775225
W/17/20D9 12:55:R1 PM Jean A1borioo
1 or 2 RRo Fes:$11,D Doc Fee:0.00 GARFIELD COUNTY CO
POWER OF ATTORNEY.
KNOW ALL MEN BY THESE PRESENTS, that Williams Production RMT
Company, a Delaware corporation, having its principal place of business in the City of Tulsa,
County of Tulsa, State of Oklahoma, hereinafter sometimes referred to as the "Company," does
hereby make constitute and appoint Sandra. J. Hotard with the full authority hereinafter
provided, the true and lawful Attomey-in Fant of the Company, authorized and empowered on
behalf of the Company and in the Company's name, and for the sole and exclusive benefit of the
Company and not on behalf of any other person, corporation or association, in whole or in pari,
to enter into, execute, deliver, file and accept all instruments and documents affecting the real
property or real estate rights of the Company the following described instruments and
documents:
(1) Agreements that grant easements, rights of way, licenses, or permits;
(2) Releases and Partial Releases of easements and rights of way;
(3) Agreements allowing encroachments onto easements and rights of way owned by
Company;
(4) Agreements subordinating easements, lease or mortgage rights;
(5) Agreements relating to the modification and relocation of facilities;
(6) Rental or lease agreements and all notices related to lease agreements;
(7) Agreements modifying, amending, renewing, extending, ratifying forfeiting,
canceling and terminating any and all of the aforementioned types of instruments
and documents;
Agreements for the purchase or sale of real property or facilities; and
Agreements to obtain the provision of utility services to facilities.
(8)
(9)
with such terms and conditions as said Attorney -in -Fact shall deem proper and advisable, giving
and granting unto said Attorney -in -Fact full and complete power and authority to do and perform
any and all acts and things as may be necessary and proper in the premises. This Power of
Attorney Anil remain in full force and effect for twelve months from the effective date of this
Power of Attorney unless terminated sooner by an officer of the Company.
Not by way of limitation, but by way of confirmation, the powers of authority conferred
shall extend to and include any and all of the instruments and/or acts above described which may
pertain to lands of the United States of America, or to be acquired by the United States of
America, lands of any state, lands of any fee owner, and tribal or allotted Indian lands.
llI writ PLZ 'iii r i ) ill
Recception#: 775225
eaf17/2p 9 12:65;31 PM Jean fliberioo
2 of 2 Roc Foe:$MOG Don Fee:0.00 GARFIELO COUNTY CO
The Company hereby declares that each and every act, matter and thing which shall be
given, made and done by the said Sandra J. Hotard in connection with the exercise of any or all
of the aforesaid powers shall be as good, valid and effectual to all intents and purposes as if the
same had been given, made and done by the said Company in its legal presence and it hereby
ratifies whatsoever the said Attorney in. Fact shall lawfully do or cause to be done by virtue
hereof
IN WITNESS WHEREOF, Williams Production RMT Company has caused this Power
of Attorney to be signed as effective as of September 17, 2009.
WILLIAMS PRODUCTION RMT COMPANY
By: efl#Z,Z14;—.
Name Alan C. Harrison
Title: Vice President
STATE OF COLORADO )
ss.
COUNTY OF A4e )
BEFORE ME, a Notary Public in and for the State of Colorado, on this ) 7C y of September,
2009, personally appeared Alan C. Harrison, a Vice President of Williams Production RMT
Company, who acknowledged to me that he has executed the above POWER OF ATTORNEY
as his free and voluntary act and deed and as the free and voluntary act and deed of Wiltiams
Production RMT Company for the uses and purposes therein set forth.
Given under my hand and seal the day and year last
MY COMMISSION EXPIRES:
DASA R. BRYAN
NOTARY PUBLIC
STATE OF COLORADO
My Commission Expkei 10122120 1
NOTARY PUBLIC
Commission No.: c 00 740'3 9X09
GENERAL PERMIT CONDITIONS
DOMESTIC WASTEWATER
VAULT SYSTEMS
AUTHORIZATION TO UTILIZE A VAULT SYSTEM UNDER TFIE GARFIELD COUNTY BOARD OF
HEALTH "INDIVIDUAL SEWAGE DISPOSAL SYSTEMS REGULATIONS"
The Garfield County Board of Health "Individual Sewage Disposal Systems Regulations" adopted in 1994
pursuant to current guidelines of the state board and adopted in compliance with Section 25-10-104(2), (3), and
(4) C.R.S., shall govern all aspects of permits, performance, location, construction, alteration, installation, and
use of individual sewage disposal systems of less than 2,000 gallon per day design capacity.
This permit specifically authorizes the entity(s) listed on page 1 of this document to install and utilize a vault
system, as of the effective dates stated on page 1, in accordance with permit requirements and conditions set
forth in part 1 hereof. Any vault system installation authorized herein shall be consistent with the terms and
conditions of the permit.
SEPTIC PERMIT NUMBER SEPT -9-10-1744
WELL SITE LOCATIONS (APD#(s)) RWF 44-32
OPERATORS NAME Williams
A. GENERAL:
Vaulted wastewater systems are not permitted in Garfield County for any facility that will generate 2000
gallons or more of wastewater per day. A vault system as permitted by Garfield County is allowed only
for limited use occupancy with a cumulative usage period of less than one year and for occupancy of 24
or less people, only on property which cannot accommodate a sewage treatment system. Vault
systems are allowed on oil and gas well pads due to the limited development time frames and limitation
of on site disturbance set by the Colorado Oil and Gas Conservation Commission, the United States
Forest Service and the Bureau of Land Management.
A vault, as permitted by thelocal board of health, shall have a minimum 1000 gallon effective capacity.
B. TERMS AND CONDITIONS
1. Minimum, horizontal distances from the various components of a system to pertinent terrain
features, including streams, lakes, water courses, springs, wells, subsoil drains, cisterns, water
lines, suction lines, gulches, dwellings, other occupied buildings and property lines, shall be in
accordance with the following "Table of Minimum Horizontal Distances".
2. No vault system shall be installed in a floodway.
3. When a system is installed in a 100 -year floodplain then the system shall meet or exceed the
requirements of the National Flood Insurance Program. The system as approved by the Garfield
County Building Official or his/her designated agent shall be designed to minimize or eliminate
infiltration of floodwaters into the system, and discharge of the system into the floodwaters.
4. Only tanks that have been certified by the Colorado Department of Public Health and
Environment shall be used for a vaulted system.
5. All tanksshall be installed in accordance with the manufacturer's specifications.
6. Watertight vaults shall not allow infiltration of groundwater or surface water and shall not
permit the accidental or intentional discharge release of wastewater or liquids to the ground
surface or to waters of the state.
1
7. Vaults shall not have an outlet unless designed to flow to another tank in series for the purpose
of increasing holding capacity. Such outlets shall be water tight.
8. Tanks shall be so constructed and installed as to withstand earth and hydrostatic pressures when
filled and when empty.
9. In locations where groundwater may cause instability problems to the vault due to flotation, the
tank shall be anchored in a sufficient manner in order to provide stability when the tank is
empty. The method of anchoring must be approved by the Garfield County Building Official or
his/her designated agent prior to installation. The local authority may require the design of the
anchoring system to be prepared by a Registered Professional Engineer.
10. Each vault unit shall be equipped with an access manholelocated to permit periodic physical
inspection and maintenance of all the tank and removal of the waste contents.
11. Components shall be so designed and constructed that when installed in accordance with
manufacturer's recommendations, they shall be capable of being easily maintained, sampled,
drained, pumped, inspected and cleaned.
12. The surface of the ground over the vault system must be restricted to activity or use which will
allow the system to function as designed and which will not contribute to compaction of the soil
or to structural loading detrimental to the capability of the vault to function as designed.
13. All metal surfaces shall be properly coated to prevent corrosion.
14. Plumbing fixtures, grease traps, building sewers, vents, sewer lines and other appurtenances
shall be designed, operated and maintained so as to comply with the minimum requirements of
the International Plumbing Code.
15. All wastewater lines used in individual sewage disposal systems shall be constructed of
compatible pipe, bonding agent, and fittings.
16. Where plastic pipe and fittings are used, the mhuinzum wall thickness of the pipe shall conform
to ASTM Standard D 3034, or equivalent.
17. All electrical work, equipment, and material shall comply with the requirements of the National
Electrical Code.
18. A signal device shall be installed to indicate when pumping is necessary.
19. The permittee shall provide for maintenance and cleaning of the vault system through a legal
contract with a company experienced in the removal, proper handling, transport and proper
disposal of the vault contents.
20. Disposal of waste materials removed from a vault system in the process of maintenance or
cleaning shall be accomplished at a site approved by Garfield County in a manner which does
not create a hazard to the public health, a nuisance or an undue risk of pollution and which
complies with state and local rules and regulations.
21. When the use of a vault system is terminated or the vault system is relocated, the contents of a
vault shall be properly removed and disposed of and the emptied vault shall be filled with soil
or rock, or the Garfield County Building Official may allow the vault Lobe reused, removed and
disposed of properly.
C. RECORDS
The Permittee shall establish and maintain records. All records shall be maintained a public records and
be made available to Garfield County or other third party upon request. Required records shall include,
but not be limited to, the following:
• A copy of the permitees's current legal contract for removal of vault waste.
• A copy of this permit.
• The dates, location, and time of pumping tank contents;
• The individual(s) and company that performed tank pumping;
• The volume of waste removed from the tank;
• The location of disposal including a receipt from the receiving facility;
• Any system repair or maintenance performed including the reason for said repair or maintenance.
D. CERTIFICATION OF AN APPROVED VAULT SYSTEM INSTALLATION
2
The Permittee shall inform the Garfield County Building Official in writing of any intent to construct,
install, or alter any vault system, no greater than 48 hours after construction, and shall furnish the
Garfield County Building Department such plans and specifications to evaluate compliance with the
Garfield County ISDS Regulations.
E. REMOVED SUBSTANCES
Solids, sludge's, or other pollutants removed in the course of vault maintenance shall be removed and
disposed of in a manner such as to prevent any of this material from discharging to the groundsui face
or from entering waters of the State. For all domestic wastewater treatment works, the Permittee shall
dispose of sludge in accordance with State (Regulation No. 64) and Federal (Section 405(d) of the Act)
regulations. The Penn ittee shall take all reasonable steps to minimize or prevent any discharge or
sludge use or disposal in violation of this permit that has a reasonable likehood of adversely affecting
the public health or environment. Permittee shall maintain a copy of a service contract and any
pumping and disposal records from the approved contracted systems cleaner and submit such
information when requested by the local regulatory authority.
F. PERMIT VIOLATIONS
Failure to comply with any terms and/or conditions of this permit shall be a violation of this permit.
The surface discharge of any pollutant identified in this permit in a manner other than is authorized in
this permit shall constitute a violation of the permit. Permit violations will be subject to enforcement
provisions as outlined in Section W.H, IV.I and N.N of the Garfield County Board of Health
"Individual Sewage Disposal Systems Regulations". Violations of the permit are the sole responsibility
of the Permittee.
G. ACCESS TO THE SITE
For the purpose of inspection and enforcing applicable rules, regulations, terms and conditions of any
permit issued, the Garfield County Building Official or his/her designated agent is authorized to enter
upon private property at reasonable times and upon reasonable notice for the purpose of determining
whether or not operating sewage treatment systems are functioning in compliance with this permit.
3