HomeMy WebLinkAboutApplication- PermitC
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N— 3 9
Assessor's Parcel No.
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner's Name
System Location
11.A
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s1L.' tresetAddresSFrte{. ��1 \��• I Phon ,��
This does not constitute
a building or use permit.
Legal Description of Assessor's Parcel No
SYSTEM DESIGN
Septic Tank Capacity (gallon)
<94/-&-/3-87-Oc7 /of 7
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 /40
CDate J Inspector Q.(,1
RETAIN WITH RECEIPT RECORDS\AT CONSTRUCTION SITE 443596 1(
•
Cktt5 Haft=
*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 involves a 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
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER 04)101-i t tt. HEb-T (09 -KP Ave A)
ADDRESS aI01 l.V -T����
%tpAs fib DR /-'DW PHONE`-z`i
r . 37191cl , /440
CONTRACTOR
ADDRESS PHONE
PERMIT REQUEST FOR (}" NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable
building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY:
Near what City of Town M (fr1z-t Size of Lot itAeAESr7
Legal Description or Address 0 1:St eat j cis Ute v3 (_a n. BA/
WASTES TYPE: S) DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE:
Number of Bedrooms 3 Number of Persons 3
(o Garbage Grinder Automatic Washer I() Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: '(gyp Dc) Ay4C otak5 AeSA) .
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: -lido c M, t -Es
Was an effort made to connect to the Community System? )-%c,
A site plan is required to be submitted that indicates the following MINIMUM distances:
Leach Field to Well: 100 feet
Septic Tank to Well: 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System (septic tank & disposal field) to Property Lines: 10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table 00 ketol>V i*Ik& ria N�
Percent Ground Slope
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
2
SEPTIC TANK
VAULT PRIVY
PIT PRIVY
( ) AERATION PLANT
' ( ) COMPOSTING TOILET
( ) INCINERATION TOILET
VAULT
RECYCLING, POTABLE USE
RECYCLING, OTHER USE
CHEMICAL TOILET( ) OTHER -DESCRIBE
FINAL DISPOSAL BY:
( )
( )
ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION
UNDERGROUND DISPERSAL ( ) SAND FILTER
ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
OTHER -DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE
STATE?
PERCOLATION TEST RESULTS: (To be completed by
Registered Professional Engineer, if the Engineer does the Percolation Test)
Minutes Al- per inch in hole No. 1 Minutes 60 per inch in hole NO. 3
Minutes iii per inch in hole No. 2 Minutes per inch in hole NO.
Name, address and telephone of RPE who made soil absorption tests: Mt,ta rau,J t D o» fed.; L,,»'w%ALink/ 1 NG.
64_ riitRt' FI#it me-. 6),(41r -flop Alit tp.41. a Ri/uVs, to C,(401
PM: ell- 0,gk5.6644 PA: enci,q4. A;
Name, address and telephone of RPE responsible for design of the system: 1c ,A,w rt. A:,i A &AAc
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and
additional tests 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. I 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 in legal : ction for perjury as provided by law.
Signed
% Date
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
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ISDS Design Plan
Lot 7 - Rapids on the Colorado
panicle npvelonment Corporation
rICEMIL HOLSwwfl
Professional Land Surveyor
LS 13501
4773 1/4 Rd.
SW Colorado
MOUNTAIN CROSS
ENGINEERING. INC.
Civil and Environmental Con.uding and Design
02610 Grand fvenu. Glenwood Spdn0.. 0061601
M 070 641 551410 170 045 0 650 +w moumd sic ress . peom
ReORC PUN R£GINPELOI75.
SMP and stocked, topsoil from
uidiig /o-Wbmt driveway: mg •
nd 8' www perimeter mound
awing before construction begins.
t Bulking Ambled boor elevation
de
, 3301.19 or above bored on
r Lot 7 moor photon.
Me ground surface sunoundn9
Se eshnor of 1M baiddg Mali
• sloped from Me foundation o
b directions with o ,Nmm+wm
Up* of B' o the tilt 10 het in
mined uses and t br tie first
7 he far pcneme t and walkway
real.
bof downspouts and dukes
Mdd discharge wog beyond to
mRs of al bacwRL
gnomon" 1.1ekh /WYSS regular
ettlY Mgahon should be locaMd
t least 3 het from foundation
aW.
. Replace stockpiled toping in
mboap•d woos.
. S•wr connection to be to
enr system or MOS system per
nem depending on avollotitity of
seer collection system.
EDGE OF RIVER
Residence Grading Plan
& ISDS Site Plan
PCBdBD L BOLCW
Profess/aa/ Land Surveyor
LS IMO?
gnMOUNTAIN CROSS
ENGINEERING, INC.
WADIN0 PMN RaitaREMEYTS
and stockpile topsoil from
4driveway. IS=
and B" wide pemruNr around
wilding before construction begins.
L Buddha finished floor e»rodon
o be 5507.19 or above bused on
r Lot 7 corner elevation.
The around surface sunwnth$
M *tor of the budding Mag
N sloped from the foundation in
W dAOctans with o minemum
dope of C N the first 70 het in
moved areas and T kr the first
0 fest for pavement and Whew
nos.
tool downspouts and drains
laud discharge well beyond the
'mite of bodfXr
.andseaping which requires regular
realy
litigation Mudd be located
d Nast 5 het ham foundation
+ads
t. Regime stockp'Nd topsoil N
andscoped arras
Awe; connection to be to
err ps em or 1505 system per
IOW depending on ordlabigb of
ewer collection *Went
•
Rapids View Lane
07/07/04
t' - 40
Residence Grading Plan
& ISDS Site Plan
�'�CgARD 1. H01Sd" r MOUNTAIN CROSS
6 0501L LWd ENGINEERING. INC.
Civil and EmFonmrnlel Conrvltlna ME Design
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Average
2
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co
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coco
.4-
r r
Percolation
Rate
Percolation
Rate
O
24.0
28.0
30.0
0
LPercolation
o
o
co 0
m in
O O
Ending
Level
32.375
Ending
Level
28.38
29.00
29.50
I 30.00 1
Beginning
—��o
M
0 n
J N
M O
CO CO
N N
I 29.50
15.00
Minutes
15.00
0 0
in 4
r r
0
6
r
Difference
15:00
Difference
15:00
000
000
its i{
r r
iri
r
•
E
H
VrMvo
WrNl�03
r
r r
r
N O
r
17:17
17:32
(0
N.
0
O
= a
DNL-
cyj
M
•
a
Average
Rate
r
co
0_
co
co
coco
.4-
r r
Percolation
Rate
O
co
18.5
Ti-
O
r
O
t0
r
Percolation
0
r
c0
0
in
N
r
L 0.88 I
Ending
Level
32.375
33.1875
in
N
o
M
I 31.125
Be • innin •
Level
31.4375
CV
29
tn
N
O
01I00
Minutes
15.00
15.00
ci
r
14.00
Hole
West
Depth
35"
Difference
15:00
000
in
r
coy
r
r
•
E
H
'o o
Wr
r
17:34 I
n
r
18:02
W O0)f0co
—ICNNN
fr)
r
0
V
r
•
a
1 Depth 1
So
Average
r
co
0_
O
W
a;
V
c
0
R
p
`
d
a
r
R
r4
co
ci
r
64.0
29.7
56.0
1
0.25
0.44
- 0.25
Ending
Level
30.25
30.5
30.9375
31.1875
0
c
c
C
d
m
Level
29.125
30.25
30.5
30.9375
w
•0000
c)0rooiNI:
r r r r
Difference
15:00
16:00
13:00
14:00
•
E
1—
' End
17:20
17:36
17:49
18:03
Start
17:05
17:20
17:36
17:49
Hole
West
Depth
35"
L0
November 4, 2005
Mr. Andy Schwaller
Garfield County Planning
108 8th Street, Suite 201
Glenwood Springs, CO 81601
MOUNTAIN CROSS
ENGINEERING, INC.
CIVIL AND ENVIRONMENTAL CONSULTING AND DESIGN
RE: Review of Lot 7 ISDS, Rapids on the Colorado Subdivision
Dear Andy:
The purpose of this memo is to confirm that on Thursday, November 4, 2005, Mountain Cross
Engineering, Inc. inspected the ISDS for Lot 7. In the professional opinion of Chris Hale, as a
professional engineer licensed in the State of Colorado, #35964, and a representative of
Mountain Cross Engineering, Inc, it appeared to be installed per the plans prepared by Mountain
Cross Engineering, Inc.
Feel free to call if any of the above needs clarification or if you have any questions or comments.
Sincerely,
Mountain Cross Engineering, Inc.
J
Chris Hale, PE
C: Mr. Gene Hilton
826 1/2 Grand Avenue • Glenwood Springs, CO 81601
PH 970 OAS Sgild • FAX• 970 QdS SSSR • www mnnntainrrncc-Pnv rnm