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Home My WebLink About04042r9i)(dr 3-a�-os 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 kit. System Location &-91-\)-1° Permit 4 0 4 2 Assessor's Parcel No. This does not constitute a building or use permit. 2 Present Address PiCiK 740 —tail ¢iP_p1� Y� P¢one Ser. PV - Legal Description of Assessor's Parcel No 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 rest sar.,„,,,,) System Installer Septic Tank Capacity /ono Septic Tank Manufacturer or Trade Name / Septic Tank Access withinwiLin8" of surface �/�r�, {/�y,�C,�.. Absorption Area u /�' 4 p d Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other Date Inspector it v" Les/lc 6. 00-eid RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION 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 fine — 6 months in jail or both). While - APPLICANT Yellow - DEPARTMENT MAR -15-05 03:18 PM REX AND LESLIE SMITH 9702855624 P.02 INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNE.R.._....,r:d'.P�G.k....Y..F_ 16.f,fSirn is i 9r'.1t f ADDRESS PC 6;44,343 4 J ' 1�.wc tS,>•e Co �G /611" PtRONE 2V 4' - ' 76% � CONTRACTOR C.,.urAn? c+n r.. 0A/5+rurli-+'a./ 04''ACfi CCS rt -.,`c. ADDR ESS/`' O Ur`/AfLSot+i....�t / 4.0, / Cere636PRONE.w7' � _s�240 PERMIT REQUEST FOR X) 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). LOC_AT1S�.D.E-PIIQPOa.ED ACI1.IT'Y_: Near what City of 'limn Legal Description or Address 7?_g / _ u-)-? WASTES TYPE: ( ) DWELLING Size of Lot 5% 4 R e e' q:TRANSIENT USE ( ) COMMERCIALOR INDUSTRIAL ( ) NON-DOMESTIC WA' ( ) OTHER DESCRIBE '.S BUILDING OR SERV(C ETYPE:_C �w.n.._y_..i.r, _. Csr±-E•.- Number of Bedrooms _,_,.,._-- N _Number of Persons—._..(e4 .-, Garbage Grinder ( ) Automatic Washer (4 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: ens tFo),:;� Aazif...1,.5T?C -Co.-- Was an effort made to connect to the Community System? b i /Beat -f../„,.,+- /&4 o.sc, s rom et.. ad n o rr...+i Cam a.... Sip? j A .4Je...toL. A site plan is required to be submitted that indic tes the followine M N1MUM distptnces: 100 feet Leach Field to OVell: 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 • 'VE_:i211i1)I.VE.DUAL, SFWAIaDISPOSAL SYSTEM .PERMIT WILL NQ BEISS[.;_EDW_ilF,IIt7_IUT �._SIli' PLAN.Y=AJCr/•arc t. r .. llS2 _N(...i'i.... . MONS: To' SE .CSE 7 -Pah"' c=am IS Depth to first Ground Water Table Percent ground Slope MPR -15-05 03:19 PM REX AND LESLIE SMITH 9702855624 P.03 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ()4 SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE PIT PRiVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET( ) OYIHER-DESCRIBE FiNA L DISPOSAL BY; ABSORPTION TRENCH, BED OR PIT UNDERGROUND DISPERSAL ABOVE GROUND DISPERSAL OTHER -DESCRIBE ( ) EVAPOTRANSPIRATION ( ) SAND FILTER ( ) WASTEWATER POND WILL. EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?_.,_ 41Q-_ PERCOLAi1ON TESL J ESULTS; (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: Nano, address and telephone of R.PE responsible for design of the system: Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional tests and repots as may be required by the local health department to he made and furnished by the applicant or by the local health dcprutment 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 he 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 sante 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 Date PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! MAR—I5-05 03:19 PM REX AND LESLIE SMITH I mr 9702855624 P.04 X 0 _ Q., _ 6'n g 01 "Fit .7s1 c n tt N • ,.. ;+.1,. ; 8 0. ''') tr.ri .".• 6' i 9 )rt, it r: ff, rt "C'.1 z n $4 2, - =- - .- 0 8 a. F \J vi cr 3 - ,..._ pi::•'! & ; - • w -e. 0c :--; (no 14 n! w. c: -, 0- z. .... • 0 0 g :3 4 n, R o- -- LPh lItvi ...• . ... • 5 5 a- $2 ni v, b \ (lit, CM C./ 0 z". 2 egp.""-•-• e=—..itt: EP fiG2tv Ftr Pr( Ake 0 00 a = 1 MAR -15-05 03:20 PM REX AND LESLIE SMITH 9702855624 P.05 05 03:18 PM REX AND LESLIE SMITH 9702855624 P.02 Cop arc r15{no� tissFoto /2-1)oC New QA> i i Nj z v 0-R0 rp INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER 11T f Nr G /6/4,7v. ' gs'!prasia . ir./t4'T7 r ! �� Q�,3S- PHONE 2-rl5 X6`/6 ADDRESS �'Q. 3 3 new CON'( RACTOR C.Ura,tr6+n .t. (.-0.1.5'+Zr 'Q./ 'Arg Cite, ADDR ESV:, &tr. , eAr&rt4...dt-M.c. C,8406PHONE'2g -2 (9 (7O PERMIT RE:QL.EST FOR .) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4). LOCATION OF P QPOS.LD FACILITY: Near what City of Town 8 1-1-1 ,.. 44- IL.") Size of Lot el ,Oe,ees Legal Description or Address__...! 2_0 / C r� uR.:--_.__"3 0 G ..-_---------------...---._. WASTES TYPE: ( ) DWELLING TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER -DESCRIBE BUILDING OR SERVICE TYPE: t.s �.1y ✓r___. 1-er Number of Bedrooms-.-------- 41 t/ Number ofPersons —..,...._.--- k4 Garbage. Grinder ( ) Automatic Washer (xj Dishwasher SOURCE AND TYPFF OF WATER SUPPLY:_,(4 W EI.I_ ( ) SPRING ( ) STREAM OR CREEK lfsupplied by Community Water. give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: �✓Pf,rt)x;,...A+L, ...4.5 -Dosch \Vas an effort inade to connect to die Community System? Ai cb, 7r9+ 4.....,.-÷ /1/44 a.M s re7A (Lt. Rd c 0 JC. 4Ji� WA t•..- Sq % .a....t rJ...l.,....ot A. site plan is required to be submitted that indic tes the following MINA IUMAiit$nces: 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_PS'_Dl al.ER AL._Sk WAGE: DISPOSAL SYSTEM PERMIT WILL Nig BE ISSUED W1,Tn-QUT .A. Sl T:E_PL,AN. Ci ft N.j) CO.N.)1T;IC)NSI 77 GSE- L "r,r /hwe: /-> 'Sr- 674vG-/11)ezrc� r. Depth to first Ground Water Table f%VkvoLa/3 Percent Ground Slope -t- J �� TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 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 UNDERGROUND DISPERSAL ABOVE GROUND DISPERSAL OTHER -DESCRIBE EVAPOTRANSPIRATION SAND FILTER WASTEWATER POND WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? fYO PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes / 0 per inch in hole No. 1 Minutes tO, f per inch in hole No. 3 Minutes 14. j per inch in hole No. 2 Minutes I/i 7 per inch in hole No. l9Y C."7-7.1 Name, address and telephone of RPE who made soil absorption tests: /r_,5"/ G c $'nar./ 2 '7 / /.o// S,/7 - F7 rAilic 4//its' - .2*? 5" -- Name, - - Name, address and telephone of RPE responsible for design of the system: /05/, 6 6 144,a0,1 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 von said application and in legal action for perjury as provided by law. signed Date 'LEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! N s z/k y C7 O L .<.e r; O /12 pe/22p c m 53 C N O 0 U 2 A\ Ac/75 e 4\11' 71 r, , / 7; • , ‘ t i i ,:. ... 1 tAyArtv4:,„ 111O ycl7 it . 0 frAg?:j4 b21:41 „It? 4.1 N5Ematr vkikA_DETAAL, DorritEikarr IdV-ArA 50-14 Get (-la a itaf_unttp frobtonanne 13/45/46 FAX TO: CORNERSTONE CONSTRUCTION 23 HOLLY WAY PARACHUTE, CO.81635 (970) 285-5624 ,F'6.xp ;r1/TN 67Q ale , Jou �cL,J5 O 0 1/41 /t4-49 , fli�J' -�.-. PAGES INCLUDING COVER SHEET 90 1/4-,1lv�,tI COMMENTS : tAQ — f L c— y\r. t__.-� e„ Ie7`I20 6 gP t rcY1 t"cc s 1,% 0 /J rx-5- l�/S �/ ( f L rt.. A i' ,7 i �� V- L +oma- ' // U� /LrE?r (A,0 /J r',f3 4A/7 rt 01/4) FEB -16-06 03:55 PM REX AND LESLIE SMITH FAX 1'0; 9702855624 CORNERSTONE CONSTRUCTION 23 HOLLY WAY PARACHUTE, 00.81635 (970)285-5624 ,P.eac m/Th 672 oe PAGES INCLUDING COVER SST frig �.e ✓ A t �2.,.,.__ .. 41 / C0 .._ h4dENTS • �A`x e r-Ar.�� _._......._.........---........ _. C 0I� S("�o0L� . �c, c,+:„G+va �..J�_� OrrUV v� P. 01 e._v./w,A -�`o/.) (r€; + ib•2 2 �� I�.IIA it; Pn�y. 4/ 4.._e / CIAO/ 5 , / .r .i -1.„,,t. ,) neoIt ky Ct//A+; 6y& r57r ifAuk (c it /1 lPev r ,.1.., RECEIVED FEB 1,6 2006 GARFIELD COUNTY BUILDING & PLANNING FED -I6-06 03:56 PM REX AND LESLIE SMITH 9702855624 P.02 Et" t 34_'' 4r ck;AI! u. . i at t yu{ c4 Mt Crick, act <1)1 10 W c,.ti., t_ap Ire Oti Wit. CV L - aa'�+�r' MA SP—fi! eet- t -+crus E STS wt.° Arta t+r T mte s-/ 1 sie‘ • • • ZO'd tZ9SSSZ0L6 � a d ., a++v n HIIWS 3I"1S31 QNtl X321 Wd S'5=90 40-80-dtlW APR -20-07 11:04 AM REX AND LESLIE SMITH To whom it may concern: 9702855624 P.02 Leslie G. Wood 23 Holly Way, Parachute, CO 81635 April 16, 2007 this is to advise that I am a Registered Professional Engineer licensed to practice in Colorado. 1 designed the sewage disposal system for the Battlement Mesa Schoolhouse Restoration located at 7201 County Road 300. I also inspected the construction of the leach field on 2 occasions. The construction was in reasonable close tolerances to the plans. Sincerely, Leslie 0, Wood 91u.