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Home My WebLink About04144w �!fi.:."?7'M1 ..::i �•.:s r �:.;%,sR+ 31 cir: si w - °j'31n iwF Sri 1v ^-- GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name ,1__�-1�-%� a_- Present Address nrt VI( il ,• (' l�• k1i System Location `7�� t /11 C 1-\ l "r` , fti-cqos' Permit 414A. Assessor's Parcel No. This does not constitute a building or use permit. 9 o -t/SCG Phone .1 Li '3c.>`7 Legal Description of Assessor's Parcel No LK-) % — t 0- Lof l 1bnnncA rnDx svi3 EysYYQ. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) Required Absorption Area - See Attached 2' Special Setback Requirements: Date Inspector 7 itri/7-1-it FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation 7 -i !1 System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area rr_ / .1) Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other // / t Date 3-3.:. Qb Inspector I ! ,. 'k ( / ///'i • i 1 RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE N (/ V *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 174M94 A, /'i�/1//5y-t' ADDRESS jg / 57_ ,4 9 55fl /mon t/T E 6/%PI'7 ONE Ylc��y�=,Ya CONTRACTOR i / i�- ADDRESS PHONE PERMIT REQUEST FOR (G-)" 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/EA/P/4 y(/% � (% Size of Lot go A Legal Description or Address ? r/ WASTES TYPE: (k)--6-WELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER—DESCRIBE BUILDING OR SERVICE TYPE: ' "3 G /tl F/P.4,u j2(ifNumber of Bedrooms r 5) Number of Persons 19 - (if -Garbage -Garbage Grinder (kr—Automatic Washer (G) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (P)/WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: / f - f] Was an effort made to connect to the Community System? ,4Zy 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 Percent Ground Slope l 6 r6 A TYPE QF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: SEPTIC TANK ( ) AERATION PLANT VAULT PRIVY PIT PRIVY ( ) 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 FIL 1 ER ABOVE GROUND DISPERSAL ( ) WASTEWATER POND OTHER -DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? /vC 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. 3 Minutes per inch in hole No. 2 Minutes per inch in hole No. Name, address and telephone of RPE who made soil absorption tests: Name, address and telephone of RPE responsible for design of the system: 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 action for perjury as provided by law. Signed 773 Date Aa 9 PLEASE DRAW AN ACCURATE MAP TO YQUIJ&OPERTY!! .b G) 0) U 0 V 0 4.1O Y Designate North Arr tI INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER V4.Nl�-. 2jTX-C-/ 3T5 ADDRESS ?ARMC{ i rte, Cc% %/ (-i.3 CONTRACTOR G.ARRY k007( ADDRESS ?�S�taNiFifNiter tz. '124,\),c-41TE , C0 1)!(G. S PERMIT REQUEST FOR ( NEW INSTALLATION PHONE (91C) -Z.5� .619/1/ PHONE (770) 2S6 6/v/9 ( ) 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 Townyml-kE44(,i E Size of Lot c-:0, 3 kce-e Legal Description or Address WASTES TYPE: (, DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Number of Bedrooms Number of Persons Garbage Grinder ) Automatic Washer X) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? 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. GROUNDCONDITIONS: Depth to first. Ground Water Table . Percent Ground Slope TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 2 02/15/2006 21:16 2400998 riRpr : Mcurita.]ncrassEng, 1r� SEPTIC TANK VAULT PRiVY PIT PRiVY CHEMICAL TOILET( ) ARRY D KNOX PAGE 02 FRY NO. ; 970945555£3 Fe c. 15 2036 03: 5 iPM P7 ( ) AERATION PLANT ( ) COMPOSTING TOILET ( ) INCINERATION" TOILET OTHER -DESCRIBE FINAL DISPOSAL RV: ABSORPTION TRENCH, BED OR. NT ( ) UNDERGROUND DISPERSAL ( ) ABOVE GROUND DISPERSAL ( ) OTHER -DESCRIBE ) VA.ULT RECYCLING, POTAi3LE PSE ) •RE(.`VCl-INO. OTHER USE ( ) EVAPOTR.ANSPIRAT'ION ( ) SAND FILTER ( ) WASTEWATER POND WILL EFFLUENT BE DISCHARGED DIRECT(' LY INTO WATERS OF THE STATE? ___1204:02,4,/a&IaLataLLIS (To be completed by Registered Professional Engineer, lfthe Engineer does the Percolation Test) Minutes "33. 3 per inch in hole No. 1 Minutes • O er inch in hole NO. 3 Minutes 3 i. 3 per inch in hole .No. 2 Minutes_ .__Pi& per inch in bele NO. Name, address and telephone of RPE who made soil absorption teats: Nd i _ c$< isS i)(a/1-)lf ll,)t;� K, 6U C4 l<; Ay -Er g y , Cakitri LJCOD- 1 Cel C_O `SI U C a C Name, address and telephone of RPE responsible for design of the system; u - . S • - C!4fj /I_AL-E `6 6.1-60 ooD - 4�rNf , co %1601 (.ago.) 94/ ..54'1,1 Applicant acknowledges that the completeness of the application is conditional upon such thriller' mandator' 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 rales and regulations made, information and reports submitted. herewith and required to be submitted by tic' applicant wetly will be represented cc be true and correct to the hest of my knowledge and belief and are designed to he relied on by the local department of health in evaluating the spine for purposes of issuing ;he permit. applied tin herein, 1 further understand that any falsification or,riiarcpresetttation 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 PL SE DRAW AN ACCURATE MAP TO YOUR PROPER TYi I FROM :MountainCrossEng, Ince FAX NO. :9709455558 Jul. 31 2008 05:12PM P1 Mountain Cross Engineering, Inc. Civil and Environmental Consulting and Design 826 % Grand Avenue, Glenwood Springs, CO 81601 Ph; 970.945.5544, Fx: 970.945.5558 FAX TRANSMISSION MEMO DATE: 07/31/08 NUMBER OF PAGES (INCLUDING THIS COVER SHEET) TO: David Mead, Garfield County Building Inspector, #384.3470 FROM: Chris Flalc P RE: ISDS Inspection of Knox Residence 325 Juniper Hills, CO The purpose of this memo is to confirm that on March 3, 2006 Mountain Cross Engineering, Inc inspected the ISDS for the Knox residence. In the professional opin.i.on of Chris Hale, as a professional. engineer licensed in the State of Colorado, #35964, and a representative of Mountain Cross Engineering, Inc, it was installed per the plans prepared. by Mountain Cross Engineering, Inc for the project. Feel free to call if you have any questions or comments. o' 0 0 0 co rn 02/17/08 40 atm Hale ign CB 1g\—rl21 ISDS SITE PLAN Knox Residence Mountain West Construction MOUNTAIN CROSS ENGINEERING, INC. Civil and Environmental Consulting and Geslgn on =Grand Avenue Glenwood Springs, CO 81601 ph 111111/48.654416 010.945.5550 pwmwnttcmuanp.w^ DAZE 02/17/06 1'-A0 GREER cert. Hale Deis 393-021 N 1 N � I a� N.R ��C � _ lI ° r _ � n r o ISDS SITE PLAN Knox Residence Mountain West Construction it --- MOUNTAIN CROSS ENGINEERING. INC. avII and Environmental consulting and Design 026112 Grand Ave ram Glenwood Springs, CO 81601 p6 970.945.5544 M1 910.615.5558 wa ..meunlalnnweenp.wn /7 > a 02/17/08 Not to Scols KINnrn Chris lisle ESDSDasign 393-021 > 1- 4 4 4 a a 4 4 51 a a ISDS DETAILS Knox Residence Mountain West Construction $�0 MOUNTAIN CROSS ENGINEERING, INC. Civil and Environmental Consulting and Design 6261/2 Grand Avenue Glenwood Springs. CO 81601 ph 070.045.5544 h 070.0455550 www.meemelnerosa8q.wm