HomeMy WebLinkAbout04130(SO, do tfrO5
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit
4130
Assessor's Parcel No.
(3-co .3,;.1R
This does not constitute
a building or use permit
nuc Kht1aer IC g4 frr'`Ma►tl/229/ 5(4,11111i or. (ij leg/6�3 963- 9b6 f
Owner's Name �'{/. �/(� Present Address Phone
System Location LiP75 C- \ I (3 C'&a(e1 0 g 11 o�a3
Legal Description of Assessor's Parcel NolIti' 3 tito ` 8X"4- of o r
SYSTEM DESIGN
Septic Tank Capacity (gallon) 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 regulationsirequirements
Other
Date /3/16?
5/l6?
Inspector
*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.O0fine —6
months in Ian or both).
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RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
lin
ift-
White - APPLICANT VeIinw. fPPAPTUFMT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
/�oserriar ear4ho/der fi
OWNER �otlei i%//erinnnt.
ADDRESS O./ Scion Y re trhn!/a/e, Co r-sm,2 3 PHONE 77o A.3.706 sr—
CONTRACTOR andro
ADDRESS 8-C-SeAce• GIen[vodirlyJ,t S)60/ PHONE 9O.9?.sG6ss
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
r,1yyJpp/C. Size of Lot /521 cues f
5'175"Gu �*�yRood //3 (adfie 0-eeE.G.d) 063 85¢ ¢. t
Legal Description or Address Zof 9 ,'Vknf .E.Ae f7on
WASTES TYPE:
94 DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER -DESCRIBE
BUILDING OR SERVICE TYPE: p/%le 72 -elide e_
Number of Bedrooms) Number of Persons 2
('4 Garbage Grinder (<1 Automatic Washer OQ Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (X) WELL ( ) SPRING ( ) STREAM OR CREEK
if supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: ilnh/iotvit,
Was an effort made to connect to the Community System? /Vo
A site ' lan is re s uired to be submitted that indicates the followin ' 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 220 r' Co. Grater'/cPJauraes WP/4eentif
U �z1309
Percent Ground Slope /0 ° — 39% SMyer er W] f bcof PC/l ,et" /o S¢3/
2
( SEPTIC TANK ( ) AERATION PLANT ( ) VAULT
( `)' VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) 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? i3e1 PERCOLATION TEST RESULTS: (To be completed by
Registered Professional Engineer, if the Engineer does the Percolation Test)
Minutes ,7. (t per inch in hole No. l
Minutes lT C per inch in hole No. 2
Minutes
Minutes
per inch in hole NO. 3
per inch in hole NO. f
Name, address and telephone of RPE who made soil absorption tests: A-17 G & fl' ' 4-(/ 131, ZC
(cur -n/ prA 7 1611 t_E (reI-1-ciTC.. `/0"-;e .7475�r'
Name, address and telephone of RPE responsible for dcsign of the system: HLt,t OA/iv c am,
ft -kik fRlAfr / gki-Gr L --)11204-F ( C
rrt.r;tr< < 5%/2/
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 arc 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. 1 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 • •erjury as provided by law.
Signed
Date
150 c
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
Designate North Arrow
Co etn5' /load //3 Ca
e Oee4'odJ
County Road (Note the Road Number and Name)
August 31, 2006
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 ISDS for 4175 Cattle Creek Road, Halterman Residence
Dear Andy:
The purpose of this memo is to confirm that on Thursday, August 31, 2006, Mountain Cross
Engineering, Inc. inspected the ISDS for 4175 Cattle Creek Road. 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 Engineeting, Inc.
' I
Orris
Hale, PE
C: Mr. Bruce Barth, #866.431.1950
826 1/2 Grand Avenue • Glenwood Springs, CO 81601
PH• 970 945 5544 • FAX- 970 945 5558 • www mountaincross-eng com
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`Ce 517-0021
ISDS DETAILS
Halterman Residence
Red House Architecture
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MOUNTAIN CROSS
ENGINEERING, INC.
Civil and Environmental Consulting and Design
826 112 Grand Avenue Glenwood Springs, CO 61601
ph 970.945.5544 h 970.045 5558 www.mwnlelncronang.com
4-001 93O PC PPE, Ii4T1 0")
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06/09/05
Not to Scale
IngEER Chrb Hale
DIG FEE ISDSDudgn
XiD 517-0021
ISDS DETAILS
Halt rman Residence
Red House Architecture
111
9 14
bPp
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MOUNTAIN CROSS
ENGINEERING, INC.
Civil and Environmental Consulting and Design
626 112 Grand Avenue Glenwood Springs, CO 61801
ph 970 945 5544 h 970.945.5558 www.mounl.incrowan9.com