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Home My WebLink About01759 ?+i"AaN"NrAER'l5 0 ) s---- GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 4 ^ - I This does not constitute 0 INDIVIDUAL SEWAGE DISPOSAL PERMIT f i it a building or use permit. Michael McVoy Owner ,1 0181 Crystal River Rd. Carbondale ' System Location Licensed Installer Conway Construction u 6 ond itional Construction approval is hereby granted for a / �� gallon �l. ' z 0 u-„ I I� . ' C / 9 iF' 9 Let - Fe K(2 /o r IF t W __L._ Septic Tank or Aerated treatment unit. 4.011, ' 5'Ar ay ' yi .toter ,: 73rd "� Absorption area (or dispersal area) computed as follows: tN„ ;, PPres of one inch in / 0 minutes requires a minimum of ,.7 .2 W sq. ft. of absorption area per bedroom. 2-u �i Therefore the no. of bedrooms k x a sq. ft. minimum requirement = a total ooPita I 45.-- ft. of absorption area. `i r ', , . —_ , . • I nspec S -, % ` `S _ t ic it i r g 34-leer. t . . /,r--�-a-� ,c—^ p May we suggest: r • .1 Date r "1 U )-- � ��NA� APFROVALOESYSTEM: e , oTE' , '- S- �' P�^oowts rise 2¢ fro .) qL" 1 1, =' iii; ' 4o system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is a -r' ing any part. Y Approved prior to cover- N g I! Pt ^C . Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface r Proper materials and assembly. Ar 111 Trade name of septic tank or aerated treatment unit. r, Al ' ) I , / r Ad equate absorption (or dispersal) area. . e y $ . Adequate compliance with permit requirements. i ' + 1 t----- Adequate cornpiiance with County and State regulations /requirements. /_ Other' Cj D a ,5 t . . ✓ " / a - Inspecto •L ( 4 a,. RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE r , E `CONDITIONS: '1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter 25, Article 19 C.R.S. 1973, Revised 1984.. 2. This permit i8 valid only for connection to structures which have fully complied with County zoning and building requirements. Connection to or use with any dwelling ar structures not approved by the Building and Zoning office shall automatically be a violation of a,requirement of the petmlt and cause for both legal action and revocation of the permit. 3. Any person who constructs, alters, or installs in Individual sewage disposal system in a manner which involves a knowing end material variation from the terms orspeclflcations oohtalned In the application of permit commits a Class I, Petty Offense •15500.00 line — 8 months in Jail pr both.). tw :tr.) + ( ; Applicant: Green Copy department:-"Pink Copy 11/1111, Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by County Official: OWNER it lC flrte( Q 4 o1 ADDRESS Bak e( 4* for/ PHONE W3 2 — /33 CONTRACTOR Co H W / at ` o sir t-t t - e aet, C e� ADDRESS (9bo 1cd- /°2 ear1ons PHONE % <3 722 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 FACILITY: / C I ounty (Tarr . ' r a (q0 n Near what City of Town Ca Pp s Lot Size Legal Description /o f q Ro Creel! cu6c#j , S /d, WASTES TYPE: ( 1//) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: ( q q (e .(;%14117(t1 Number of bedrooms 9 •JJ Number of persons ( ) Garbage grinder (/) Automatic washer (//) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: If supplied by community water, give name or supplier: eo,ajnimi Work( fron, Sei /VdisAo, l 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: (1) 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? h o 1 • • • Panel 9 - r SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) 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 of issuing the permit applied for herein. I further under- stand 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 per- jury as provided by law. Date 46.42 Z8' /y 90 Signed GI_j PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • Page 3