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Home My WebLink About01136 4 toARFI LD COUNTY 8UI1 ii 1 N 1 S ANITATION DEPARTMEN P u 1 a l i Lu �� 1 Ill ii a a a elenwclp I1 �p1 a a ra 4/o2✓'— r2.5'/ 'I(/ /.: . :I,' !4I� ' m � t b 31941114941 1 , Iai Nw-1111@ I "11 61 e .. 1 +m1 1ti yra ;a . Ibis d. es not co nst1 u I l !" 4 I ,. u� „ 11 f , '" h LUIDUAL SEWAGE I Ii�J ` L PERMIT 0 '11" N I a building or use e ',in, I�h „„.„,11,,,,,I, 1!'111 Owner Jim 8 .Linde BI�nSon I� , " ° ,, c I' ,F N1 +I ' i� 11w1 Lot 6, Bik 5, Unit 1, Eik 11 ek Subdivision Dr206 ( ./roe4 le / „ii „II b ystam Location I V i 1 Licensed Installer ,. 11 1t ) 1 " " • Conditional Construction approval is hereby granted fo 1 0 7 gallon W II11 - X XX Septic Tank or ,.._.Aerated treatment It, . it 01 p il l I I Absorption area (or dispersal area) computed as follow*: ,, I s I F - . �1 Pere rate of one inch In ' min tes requires min 1 m of , /� / sq. ft. of absorption`erea per bedroom. - h " 11 " h Therefore the no. o bedr � o x 1 l'' tq. � i � u r gir t b t o4sf ,e, i I M aYwesu est /D K /O , X D / / 4 1 i^ Da A -tn.L4 Z -' (O r I 1 8�2.J "r 1 Inipebtor C r 4- , •c. r a-r rc 1 t'i'i° - ' F INAL APPROVAL OP SYSTEM: 1 11 No system shall be deemed to be in compliance with then 1 1 wage Disposal Lows until the essembleasystem is approved prior to l coyer � liu I " i. . 11 , iii,A , 11„ 1119 any part. !1 ' , i 1 ! !Mir " Septic Tank access for inspection and ale ping Within 12" of ground surface or aerasedaceess ports above ground !!! I d!1 1 CI surface. 1 1 Proper materials and assembly. 1 M J 1t - '1 Trade name of, Septic tank or aerated tre meat unit. 1 11,111.111" ' Adequate absorption (or dispersal) area, 1 mm � 1- 1 rz' ,_� l� ' 0 t"' : 41 "!'! Adequate compliance with permit regbir ants, I 1 l , !! A dequate Co with County e ate SeoulatiOnSitaquireem ants. - n 1i11 J X II F' J �it .t r 1 i t 8 2— N 1 - 'J Date � i inspector RETAIN WITH RECEIPT f1R� CONSTRUCTI Silt ' 1 I 1 011 II 1, '"CONDITIONS ? 11,1 �II l 0 I ' I. All installation must comply with all requirements o 'County Individual. Sewage Disposal ltRegulations, adopted pursuant to au l 1 I, I ' .._ thorlty granted in 66.4, CRS 1963, amended 66. 1 g„,,' .I .AS 0 1 l I ° ' 2. This permit is yalid for connection to structure* ,!1 I, t 'h e ully mplied,.wIth `County orgng and building requirerfO is 1 1c „ Iw � , Connection to or use W ith anV:dwelling or structures Ao ) „ II " th Building'and Zoning Iticg shall automatically b6 ;o ylla s tion of a requirement of the permit and cause for bo'h' I #c, io I nd reeobation of the 1 �iermi t . ,1 ' ' I1 a +, 3. Section III, 3.24 requires shy person who c onstrue i 1 r s tells ale individuaiae'Vvage dIaporal system in a manner wlilch in 4 1 ! l ▪ 1 valves a knowing and materiel`, variation from the term ! r spa f canons contained to the appllge of permit commits a Oka 1 ,!1i11,i,l - !i 1 Petty Offense (S5410.00 fine ,'w I" Months in Jail or bothy 11^ a 1 ".11 1 r 1)1 I ", . il l I r" i , 9, r� > 1 Aopnunv Crain lad be n' eaeo P1nx Coov 1�1 ial r l II , + .. — .J,vwu14,....L.�.,Yo^:ai� , urrwl'✓WLrrwuu' ,. JI, ..rru,.... a r . 4.1 sal .F u - r l u ^ __ _..ate_ yu�. 14�. C .4..ry 11i_ ' �., r INNDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION PAGE TWO OWNER L 15 ADDRESS / 6. 13 Ij f4vt+ / PHONE q.9v`•-73 - q APPLICANT eel (10;421-7> ADDRESS a/ C t PHONE CONTRACTOR - --( ADDRESS y � l � PHONE y� � IS PERMIT FOR: ( New Installation ( ) Alteration ( ) Repair Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, soil profiles in test holes. LOCATION OF PROPOSED FACILITY: County Near _what ,City or Town - 7159 c , C.-or4z> Lot Size H OC' Legal Description WASTES TYPE: (✓Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe: BUILDING OR SERVICE TYPE: Number of Persons :1, Number of Bedrooms Z ( ) Garbage grinder ( Automatic rasher ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (' j well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: If supplied by community water, give name of supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? 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 ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: PAGE THREE R• WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? SYSTEM IS DESIGNED FOR GALLONS PER DAY If the system is to be designed by a Registered Professional Engineer (RPE), state rate of absorption in test holes shown on the location map, in minutes per .inch of drop in water level after holes have been soaked for 24 hours: SOIL PERCOLATION TEST RESULTS: 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 purposes 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 adopted under Article 10, Title 25, C.R.S. 1973 as amended. The undersigned hereby certifies that all statements 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 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. Date / �j( 0 Signed �� z' C -int- PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY _ MOORE CONSTRUCTION & BUILDERS Dave Moore — Contractor Box 864 Glenwood Springs, Colorado 81601 876 - 5555 Enviromental Health Terry Howard - 2014 Blake Ave. R ECEIVED J t � Glenwood Springs, Colo. 1982 Dear Mr. Howard; Moore Const. has Contracted to build a home for a Mr. &Mrs. James Benson of Glenwood Springs, Colo. on a parcel of land described as Lot 6, B1. 5 Unit #1 Elk Creek Subdivision New Castle, Colo. Beacause of the fact, that I obtained a building permit under the old county regulations relating to septic systems; and of the updating of these regulations , Ihave found that I am in violation of the setback requirements and consequently will not be able to obtain a Certificate of Occupancy. In order to releave the Bensons, The Mortgage Co.,& myself (Moore Construction) of a gross hardship; I am asking you to grant some special consideration on the setback regulations, inallowing me to be able to install the said septic system,under your direction, on the abouve property. Any and all consideration will be much appricated and needed. Your immediate attention to`this : probie.m will be muchly appricated. Yours truly; David C Moore c:Bensons