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Home My WebLink AboutApplication- PermitI3 �I} \-1.,se\ Jti-.Id cJ \�J\ ARFIELD COUNTY?BUILDING AND SANITATION DEPARTMENT Permit N`_ 3561 `��//// v 109 8th Street Suite 303 Assessor's Parcel No. l Glenwood Springs, Colorado 81601 OS- I INDIVIDUAL SEWAGE DISPOSAL PERMIT t PROPERTY Phone (303) 945-8212 This does not constitute a building or use permit. 1I n o y, Owner's Name;114tl L C?rS L`� //�Prresent Address 1 LI 7 LDFt�L,P%l�UF 171 /SP Phone 32 yJ 2_Si( 61° E- A System Location 0 13THf R Ct (In o ) Si C f` `) 019 Legal Description of Assessor's Parcel No SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Required Absorption Area - See Attached Special Setback Requirements: Date Number of Bedrooms (or other) 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 1/�' s K/1 Date Inspector Il �7�— \may, RETAIN WITH RECEIPT RECORDS AT CONSTRUCTI N SITE *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 f ine — 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT • INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER tAV e \e. Ptuac De vt.kof 'nloi 1st t`^-ir, ADDRESS . �o-, ' 7 2'1 �ler,a�oo d (6-S 516 oz. PHONE 3�4 Z S`t`d CONTRACTOR IC1 o`^^ kaA.s /a •..d Wo,l'As < • ADDRESS Po f,ot Ivo 31.<0vJoo`f c PHONE "2.16'4- - 22ut PERMIT REQUEST FOR V 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 S; k Size of Lot q a, 7 Z€ Legal Description or Address Cot 3 U Ica'lt A (-CI t r �� OA :N << 0-r. . Gas' kris 1.01 C4 y co WASTES TYPE: (X) DWELLING £s / C t- S f I TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Praha -4: th/u Q. Number of Bedrooms Number of' Persons Y ( ) Garbage Grinder ()) Automatic Washer ()a Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (Q WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: {AU 1t #crcc (tvr+n,Ny v\ 1 Wcxf cr DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? NC) A site plan h reauired to be submitted thatindicates 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 to Property Lines: 10 feet YOUR INDIVWDUALIEWAGE DISPOSAIJYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN, GROUND CONDITIONS: Depth to first Ground Water Table Percent Ground Slope 2 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: SEPTIC TANK VAULT PRIVY PIT PRIVY CHEMICAL TOILET ( ) AERATION PLANT ( ) VAULT ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) OTHER - DESCRIBE FINAL DISPOSAL BY: (X) 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? t Jo PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes per inch in hole No. 1 Minutes per inch in hole No. 2 Name, address and telephone of RPE who made soil absorption tests: Minutes per inch in hole NO. 3 Minutes per inch in hole NO. �� •� (e6(C cl' — 199? Name, address and telephone of RPE responsible for design of the system: DQRe K of f y (L ' 'f C'4/news 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,. intonation 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 action for perjury as provided by law. Signed �i^"- hat L Date PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 1a unurr EASEMENT, 209.02' N 8979 L�St%L S 8979 Ns9s4:ut 12404' LOT 2 96,414 sq. tt 2.21 oars _ Ne9r4:uT 13400' S850774 NE way 6 et ,24 (cp.0. 4) October 31, 2001 Garfield County Building & Planning 109 Eighth Street, Third Floor Glenwood Springs, CO 81601 U /� ' / Ar- i J a] J 1 07 1 - Re: ISDS for Lots 1,2,3,7 and 9 — Ukele Acres Subdivision LICE Job No. 2011081.59 To Whom It May Concem: RECEIVED NOV 0 7 2001 On October 8, 2001, High Country Engineering personnel observed the construction of the ISDS Lots 1,2,3,7 and 9 of the Ukele Acres Subdivision in Garfield County, Colorado. The observations made were: Lot 1 The tank had been buried, but it appeared that one 1000 -gallon septic tank had been installed with 24 standard Infiltrator units in a trench configuration. No additional backfilling had taken place. The owner was advised to rake the trench sidewalls, install the effluent filter and install the inspection wells. Other than that, the installation of the system was in conformance with the intent of the design. Lot 2 One 1000 -gallon septic tank and 34 standard Infiltrator units had been installed in a trench configuration. No backfilling had taken place. The owner was advised to rake the trench sidewalls, install the effluent filter and install the inspection wells. Other than that, the installation of the system was in conformance with the intent of the design. Lot 3 1000 -gallon septic tank and 112 standard Infiltrator units had beer, installed in a bed configuration. No backfilling had taken place. The owner was advised to rake the bed sidewalls, extend the outlet tee into the center of the septic tank riser, install the effluent filter and install the inspection wells. Other than that, the installation of the system was in conformance with the intent of the design. Lot 7 One 1000 -gallon septic tank and 32 standard Infiltrator units had been installed in a trench configuration. No backfilling had taken place. The owner was advised to rake the trench sidewalls, install the inlet tee in a vertical position, install the effluent filter and install the inspection wells. Other than that, the installation of the system was in conformance with the intent of the design. 1517 Blake Avenue, Ste. 101 Glenwood Springs, CO 81601 Telephone (970) 945-8676 - Fax (970) 945-2555 14 Inverness Drive East Suite 13.144 Englewood, CO 80112 Telephone (303) 925-0544 - Fax (303) 925-0547 r Glarfield County Building & Planning October 31, 2001 " Page 2 Lot 9 One 1000 -gallon septic tank and 26 standard Infiltrator units had been installed in a trench configuration. No backfilling had taken place. The owner was advised to rake the trench sidewalls, install the effluent filter and install the inspection wells. Other than that, the installation of the system was in conformance with the intent of the design. A follow up inspection was conducted on October 30, 2001. At the time of re -inspection, all inspection wells had been installed and septic tanks had been covered. If you have any questions, or need additional information, please contact us. Sincerely, HIGH COUNTRY ENGINEERING, INC. Roger 1. Neal, P.E. Project Manager 2f5 RDN/djw p� Cc: Pete Waller . IONP.t.Cr?;;;.). 1517 Blake Avenue, Ste. 101 Glenwood Springs, CO 81601 Telephone (970) 9454676 - Fax (970) 945-2555 14 Inverness Drive East Suite 13-144 Englewood, CO 80112 Telephone (303) 925-0544 - Fax (303) 925-0547