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Home My WebLink About01573 / GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 REPAIR — PERC FEE ONLY Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT N 1573 a building or use permit. Owner Clair q® _r & Aaatr$ne C. gad _ System Location 0204 301 M., Parachute, OO 81635 Licensed Installer at Ri ®ley * Conditional Construction approval is hereby granted for a DSO .Y gallon �.r,' n Y • X Septic Tank or Aerated treatment unit. a xis to /t� �^�C• / - c, re Solt fn. Absorption area (or dispersal area) computed as follows: 3.7+ Perc rate of one inch in 1 -- minutes requires a miniim�uum/'_of sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x ...�'7 "vaq. ¢ ft. minimum requirement = a total of 7¢S sq. ft. of absorption ea. /�k �-e e_ 7-1.9 7., At- el g4r fry C.� vt.r% : rrss / May we suggest: I2. �( $'b /x 3 /cfe e to o �,r /8" ( ICJ 3 � e l et • Date 8/2_07 . Inspector a C, t• ��/"_I� FINAL APPROVAL OFSYSTEM: /""" •^-No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover• ing any part. m ef Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground ' / surface. a /'c, Proper materials and assembly. t t '"' ,'// Trade name of septic tank or aerated treatment unit. tf5 /S I ✓ / n 4/ ( !c T , ' /-94i h. ,2 Adequate absorption (or dispersal) area. /O K 3 � kC kis fec/ /Pc / a y Adequate compliance with permit requirements. O i _ Adequate compliance with County and State regulations /requirements. _ Other /��( / j� .. I ri ,,e sa pt" ��yy Date ___�/ � / yj / nspecto _, ___ -- RETAIN / WITH RECEIPT RECORDS AI 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. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation of 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 — 8 months in (ail or both.). Applicant: Green Copy Department: Pink Copy '0/20/B7 Petc = / "/ z 7 1/7, 3 741 ct. /. /oeloo,, frei re 7 c Clef Fq. A 7'2 'n S'0XTet: O 'r l e X ?el aver-2 Iii l W1'L £Li,/ L ;i Ui.51 U31,L ;Si5iLL RFILIlhilthr npviU ui by County Official: ii: :, . 4 � A - ! 0 7 t)P.OVZ.ra I ,'." : $S ii g,l, * [ i. - ..r.. .,.Y, PHONE- ?S "L� 7 76 r ° 'NTRACTOR �001 '`,/S[. ." • p i � gDDRESS fl (of ( F :.y 4k ;° i .PNONEflS -763 C i ii"" „ +.. PERMIT REQUE$T FOR ( ) New Ijsta %tip ( ) Alteration (,)<) Repair Attach separate sheets or, report showing` entire area 'With respect to surrounding areas, M ,„ topography of area, habitaWe building, location of potable water wells, soil percolation "t ° test holes, soil profiles "in test holes. (See page 4.) rir, LOCATION OF PROPOSED FACILITY: County ° Crq-RF I E Lb d lid Near what City of Town jwq,RrgGFjti� Lot Size . y7y4CQc. i Legal Description /Y6 1 uT14.1:7Y Thw&Sm, 7.Son g.4 C.E. 9s Wash- of 779E S X79- A M. - ?Ale - Frt�* -D Ce li447 / Vook 7o 7 Pt it i t17 WASTES TYPE: (,<) Dwelling ,. ( ^' ) Transient Use F RI$ ( ) Commercial or Institutional ( ) Non- domestic Wastes (u ,;, ( ), Other - Describe BUILDING OR SERVICE TYPE: ir7S /a/a2cQ,. f Number of bedrooms a_ Number of persons oZ ( ) Garbage grinder ( ) Automatic washer ( ) Dishwasher .5 ,4 4 SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: .. 70' , ' If supplied by community water, give name or supplier: 7 -e }C# C.t-77 GROUND CONDITIONS: ' Depth to bedrock di, n , Depth to f i rst f ound 3Wat,t T e,c' , ` .` � .�. ate Percent ground $ ope ~ 4 ti . a ; r DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM.`'` ot$t.c. ''Was an effort made to connect to A/Or``!4Y' ,#ii 2e ' TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM " PROPOSED: b( ) Septic Tank E�,,n,.� ( ) Aeration Plant ( ) Vault ( ) Vault Priv ef" t'l ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use ( ) Chemical Toilet ( ) Other - Describe: FINAL DISPOSAL BY: 1X) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond r' ( ) Other - Describe:` ;'WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? A/0 Page 2 SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) Minutes per inch in hole No. 1 Minutes l 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 ri 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 pig Jadopted Title C.R.S. 1973, as amended. The undersigned hereby certifies statements made, represented to be herewith and correct of my knowledge and belief and are designed to be relied on by the local. department of health 4 in evaluating the same for purposes of issuing the permit applied for herein. I further under - stand that any falsification or misrepreSeaitation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action for per - :,. ,jury as provided by law. k• � Date 1 lci 9-2 /* Signe. I�� _ �.' -' PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY /5 e akillEAGOr M ft514 flos 1 150 • tie G kti Page 3 I PLOT PLAN AND DESIGN FEATURES: Include by measured distance location of wells, springs, potable water supply lines, cisterns, buildings, property lines, subsoil drains, lake stream, dry gulch and show location of from dwelling or other fixed reference object, and additional propos proposed system b direction submissions and distance o i support of this application such as data , plans, specifications, statements and 4, 1 : .:. c . i r\ Y. \ 1 i ' I ) N ‘S`, • A ■ • Z. 1 r, X tn •� " `� `� _ n i 3 / 9 7 , e l' 4P I x / � / ti -</o Page 4