HomeMy WebLinkAbout03939V
•-,..-„�M+*1u..2«I+ N'.aa,r,
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner's NameNP.AQ($YLfU
System Location 0333
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
Permit NE 3 9 3
Assessor's Parcel No.
1000
Present Address
590/—a:7 66—aa9
This does not constitute
a building or use permit.
Phones” J /Z1 a7aA
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number, of Bedrooms (or other) v
Required Absorption Area - See Attached µ,
�i /
3 2t� =�
Special Setback Requirements:
Date -� 6 -6 if Inspector /06_4 it // 7-P-,
' tZ 6(
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity /000
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface
Absorption Area
ev
Absorption Area Type and/or Manufacturer or Trade Name
4/44,4
Adequate compliance with County and State regulations/requirements
Other
Date ! / G `d/ Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
•
3
*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 i
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 'f
months in jail or both).
3
White - APPLICANT Yellow - DEPARTMENT
0
INDIVIDUAL SEWAG DISPOS�%, PLICATION
b -K Olsen �f- tSeygri
OWNER - f d (2 i , rcl ✓e ru,c�e s _L IJ cam•
ADDRESSaq_C-4d 3567 S/its�/65A PHONE_9 7D -5S76 -z 7,?
CONTRACTOR o w"le /-
ADDRESS
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 FACILIITTY:
Near what City of Town J ) Size of Lot 5
Legal Description or Address C K 3 a__
WASTES TYPE:
(4 DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER -DESCRIBE
BUILDING OR SERVICE TYPE:
Number of Bedrooms
3
Number of Persons
z
( ) Garbage Grinder (>0 Automatic Washer ( Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: 09 WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: A/A
Was an effort made to connect to the Community System? /VA
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
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(1 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:
Cv) 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? 4/7)
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 /kit)? h1/Qjc CJ Date 00— / /, - 03
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
Franlf
,/-54e1•4
OG (a y
zgg�
/'/_ Gni/
Copy ny
�S 0..scnra7 -Fpr occu+ 11,41e-1
Orve wny m
2
0
g
.5 3
X11
Pit
181
S 'Ili
o0
rerce
;a V O
tc
1: i
• .cU
111
� o
sr, t) ✓
T
� er,3
rr r
1 Li
—t
L
f
.0 . 4r
'.1 an -24 :1 r
yII Carmr Station 23
ad rear - 00 eon
Replaced tirh 3•rr2'
Alea. n,pt Caa rr.
6' bila. read surface
n
5
0
0
N.59'07'55'2,
1334.71
11.62'07.55'E, 1336.71
µ.89'09'27'E. 1333.51
5.00'16'31'E. 1323.60
n
Os ••J t.r
.sGsi sane, Ca
551 6d.r i
1.3. mart
30 f LC.
N.59.09 -37'E.
▪ LH.
5
• 51 1
time t
mfg. 4- Lu - Bol
NI24 Car3er Seer ion
F.e. 6' Spiie bolas Feld:
striae*.
Rnalgc.d all. 3-I/2'
A11..
pip. L Cop
L.J.
Tie: N.39'iN'I6 E. 2565.02
11.0313'011'3.fir'
5.1 eater 3 Co
1 l
S -SIP II.49
III.
b.9
t...k 0$5.
0...' 6 r
saie.is M..a, a. a
Eaaglfee 2
51
11.89'09'27'E. 1333.51
01
t
N.69511'02'2. 1330.73
\\ v
W1/4 C Seel ia. 23
Fed pipe / ♦le.. Cap
1.5. eat I.Sible
•
T • land lees t
Sesaa 0.
Ea.N11u 2
r
0
0
9
b•
35.456
SEI/4M11/4
sae
l.'a'.r lNir
Acres
Nii9.fl.e
8
•
. var. O..N b•
i�6. ,el Ca u
m
Nla Gerrity
0
Cnsr 1. -to
3-09.0
I!t
Set rItar & Car1.11/111'31-E..1.11/111'31-E-E 901.911.3. W11.
e/O.d
P 09.10'.-2
a 1:5.64 _
d Ordiev'
011.41
z
la: ...kw
s.i�war
41-t:719:17:1897i.
ft
2661,46
.1
sinews
1.
w0 Olad.bGrua. lad
M ..l1 .d Can is CNpa7 G
•„ 0
.I :- 2
-a
:
`Form No. OFFICE OF THE STATE ENGINEER
GWS -25 COLORADO DIV' )N OF WATER RESOURCES
• X818 Centennial 81dg.. 1313 Sherman St.. Deme+, Colorado 80203
1303) 866-3581
APPLICANT
JANE REED
4666 COUNTY ROAD 311
NEW CASTLE, CO 81647
(970)876-0229
PERMIT TO USE API EXISTING WELL
Farce
1095
WELL PERMIT NUMBER 219 9 0 3
W
DIV. 5 CNTY. 23 WD 45 DES. BASIN MD
tot: Block: Fling: Subdiv:
APPROVED WELL LOCATION
GARFIELD COUNTY
NE 114 NW 1/4 Section 23
Twp 7 S Rng 92 W 6th P.M.
DISTANCES FROM SECTION LINES
800 Ft. from NORTH Section Line
2600 Ft. from WEST Section Line
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of
the permit does not assure the applicant that no injury will occur to another vested water right or prelude
another owner of a vested water right from seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2,
unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction
and Pump Installation Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(31(b)(111(A) as the only well on a tract of land of 35.5 acres described
as that portion of the NE Yr, NW ys, Sec. 23, Twp. 7 S, Rng. 92 W, 6th P.M., Garfield County. Reference
attached exhibit A.
4) Approved for the installation of a pump in, and the use of, an existing well, constructed on 7/10/99, to a depth
of 137 feet, under monitoring hole notice MH -36507, acknowledged 7/8/99.
5) The use of ground water from this well is limited to fire protection, ordinary household purposes inside up to
3 single family dwellings, the irrigation of not more than one (1) acre of home gardens and (awns and the
watering of domestic animals.
6) The maximum pumping rate shall not exceed 15 GPM.
7) The return flow from the use of this well must be through an individual waste water disposal system of the
non -evaporative type where the water is returned to the same stream system in which the well is located.
8) This well shall be located not more than 200 feet from the location specified on this permit.
APPROVED
SAP
stn Enalm.
SFP 0 21999
Cfre
9/'/9
2001
EXPIRATION DATESEr 41
LEGAL DESCRIPTION
THE NE 114 OF SECTION 23, A DISTANCE OF 1234.75 FEET TO A POINT IN THE EASTERLY
RIGHT OF WAY FENCELINE OF COUNTY ROAD 3-C:
THENCE NORTH AND ALONG SAID EASTERLY RIGHT OF WAY FENCELINE A DISTANCE OF
1234.75 FEET TO THE POINT OF BEGINNING.
PARCEL C PARCEL 2
A TRACT OF LAND IN THE N1/2 OF SECTION 23, TOWNSHIP 7 SOUTH, RANGE 92 WEST OF
THE 6TH P.M. AND BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
BEGINNING AT A POINT ON THE WESTERLY RIGHT OF WAY FENCE OF COUNTY ROAD 342 FROM
WHICH THE SOUTH QUARTER CORNER OF SECTION 23, TOWNSHIP 7 SOUTH, RANGE 92 WEST
OF THE 6TH P.M. BEARS S. 00 DEGREES 31' 20" E. A DISTANCE OF 2805.74 FEET:
WITH ALL BEARINGS HEREIN BEING RELATIVE TO THE NORTH/SOUTH CENTERLINE OF SAID
SECTION 23 BEING HELD TO BEAR DUE NORTH;
THENCE N. 00 DEGREES 04' 08" W. AND ALONG SAID WESTERLY RIGHT OF WAY FENCE A
DISTANCE OF 902.95 FEET;
THENCE N. 89 DEGREES 10' 09' E. AND CROSSING COUNTY ROAD 342 A DISTANCE OF
415.66 FEET;
THENCE N. A DISTANCE OF 361.50 FEET;
THENCE S. 89 DEGREES 10' 09" W. A DISTANCE OF 416.09' FEET CROSSING COUNTY ROAD
342 TO A POINT IN THE WESTERLY RIGHT OF WAY FENCE;
THENCE N. 00 DEGREES 04' 08" W. AND FOLLOWING SAID FENCE A DISTANCE OF 789.76
FEET;
THENCE S. 89 DEGREES 09' 27" W. AND ALONG THE NORTH LINE OF THE SOUTH 880 FEET
OF EVEN WIDTH OF THE NEI/4NE1/4 SAID SECTION 23, A DISTANCE OF 180.48 FEET TO A
FENCELINE IN PLACE;
THENCE S. 86 DEGREES 22' 01" W. AND FOLLOWING SAID FENCE FOR A DISTANCE OF OF
531.70 FEET TO A POINT IN THE CENTERLINE OF THE WEST DIVIDE CREEK DITCH: THE
FOLLOWING TWENTY-SEVEN (27) COURSES ARE ALONG THE CENTERLINE OF SAID WEST
DIVIDE CREEK DITCH:
S. 14 DEGREES 08' 49" E. 124.02 FEET:
S. 15 DEGREES 01' 13" W. 32.23 FEET:
S. 00 DEGREES 44' 57" E. 47.43 FEET:
S. 11 DEGREES 02' 58" E. 85.14 FEET:
S. 30 DEGREES 42' 06" E. 75.40 FEET:
S. 46 DEGREES 27' 36' E. 21739 FEET:
S. 18 DEGREES 31' 13" E. 46.38 FEET:
S. 12 DEGREES 44' 55" W. 202.71 FEET:
S. 03 DEGREES 48' 26" E. 157.01 FEET:
S. 22 DEGREES 45' 58" E. 46.92 FEET:
S. 31 DEGREES 48' 31" E. 96.16 FEET:
S. 04 DEGREES 25' 58" E. 88.96 FEET:
S. 46 DEGREES 15' 51" W. 71.77 FEET:
S. 72 DEGREES 43' 28" W. 82.61 FEET:
S. 78 DEGREES 43' 29" W. 61.79 FEET:
N. 85 DEGREES 50' 57" W. 89.91 FEET:
N. 78 DEGREES 26' 14" W. 143.67 FEET:
S. 65 DEGREES 13' 23" W. 72.48 FEET:
S. 15 DEGREES 36' 10" W. 38.10 FEET: