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pp I ' GARFIELD COUNTY BUILDING AND 'SANITATION DEPARTMENT
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�ull,I 109 81h StrpP1 " t I 1 91 +' �,to 303
+ Glenwood RiiInps;�' 'Id do 81601
11I III III
Photo (303) -0212
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11 I N „ III` Thle does not constitute
ry : 1 i1 I J 'JVIDUAL SEWAGE DISPOSAL PERMIT N I
;S a building or use permit.
Melvin Perkins
A tract of ]and a nt ln& in lots 14 and 15, Seca 7'7 RBBW G.S.
a d ,�� +, 'Lobation
IP I u If Licbnsed Installer PDi7 R�s]ey C. Pi . // a C.a iCY
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IT +11 • Conditional Construction approval is hereby granted for a // 049 (1 gallon '
� '" Septic Tank or . Aerated treatment unit. G
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P"i iui.0 VI, II IaV, dd
or
Isallk t ^- Absorption area for dispersal area) computed as follows: la iv," :la
Hr' 1
ii Pere rate of One Inch in 7 minutes requires a minimum of / `/ / sq. ft. of absorption area per bedroom. 1 '' ,
WI1 ` ' Therefore the bedrooms 3 x J `// sq. ft, minimum requirement = a total of ' 73 sq. ft. of absorption Reel, 'h s l I Id
_II p N Lt, May we waged. H en X ? ' r / g'' X u2 ' '' O'✓ .2 $/e p I T'.,,i0 .v., 'O - v en /vet:* 9,7" II :
f Dat / C7' 2 /r/ Ci Inspector rag ure--1/1-,i._ S -- s { rIi
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I FINAL APPROVAL OF SYSTEM:
1, „ d111x tse
r I s l No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to Ooye+ tip'.
ing any part I ulr
ql l l i 7 wf To
1'0'00 I l +9, ” x+ 1 a r tl - 1a41
..ptic Tank access f or inspection and cleaning within 12" of ground surface or aerated access ports aboveground `I m _ '
,I i I w ; ' ` " 1'i a I i )'I � urface. ' 61
" + "- P ht
roper ate"rials and assembly. "`
1.
", F Io
I'"' w % '" -• A . - ' d" Trade name of septic tank or aerated treatment unit.
Adequate absorption (or dispersal) area. I9 ',
(Adequate compliance with permit requirements. f,'-
4„..
ll di Uate compliance with County and State regulations /requirements. 'O
ills
"r 11 „ _ Other t dl rr.
Date / �� /_ n r
d � Inspecto [`� :/L[�- "-�""'ti I, ) I q "Ail_
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«. II
: 0' RETAIN WITH RECEIPT RE AT CONSTRUCTION SITE �� nt di�.
" r 'CONDITIONS: fl
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems �y I
Chapter 25, Article 10 C.R.S, 1973, Revised 1994. ll 'l,
2. This permit le• only for connection to struotU which have fully compiled with County zoning and building
requirements. Conneotipn to or use with anydwelll r structures not approved by the Building end Zoning office shall m'
automatically be.a violation of a requirement Of the" It' end' cause for both legal action and revo0ation of the permit. ,
3. Any person who constructs, alters, or installs an IndIvI sewage disposal system In a manner which involves a knowing a i .
and material variation from the termsorapecificatlons „ InedIn the application of permit commits a Class 1 , Petty Offense
($500.00 fine — 8 months In 'all or both.).
v
Applicant: wean Copy Dapartm.nt: Pink Copy k
• .
_. _ Y ..s..._...�:..:..�.,._____,.�_.
•o •, ,, Application
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
OWNER County Official:
c..JY. h Rip c5
ADDRESS S3 g7 C&4.,. a /SY $2 G4nws4P %o'. Js PHONE 9YS - - 4 7 5C 1
CONTRACTOR Be6
ADDRESS 393 E, 2" I laenI"tt PHONE 2'S-76Y7
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
.;, holes, soil profiles in test holes. (See page 4.)
LOCATION OF PROPOSED FACILITY: County 6
Near what City of Town 8e'1'wet., 6,,,, .. 6.4.-10.-4.4 Lo Size .5.62 ac.-es
Legal Description A T r A C /e..j rO - nfsa C i 2 •Ks /y a. JG /5 et 5c*
77, ear sr k of ,QQ 1# 1.
WASTES TYPE: (7) Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: 27 56i2" 4TeK f"reIX 2 Nome_
Number of bedrooms 3 Number of persons r2
etc) Garbage grinder O() Automatic washer (7C) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) well (›C ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: /esre.
If supplied by community water, give name or supplier: CattL Creer/ Mk 9ssec ateh
GROUND CONDITIONS:
Depth to bedrock: — P,i .* e-„ y p1' 7 !gees
Depth to first Ground Water Table: 46 — be.,4art. +e be rice A .
Percent ground slope: t® "IC , / 7 . a t e Piyef.1 /4seyt , greet_
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Ca,.de -idce
Was an effort made to connect to community system? dio
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(7C) Septic Tank /° /)./, ( ) Aeration Plant ( ) Vault
CM Cr l#c
( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use
• ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use
( ) Chemical Toilet ( ) Other - Describe:
FINAL DISPOSAL BY:
(X) Absorption Trench, Bed or Pit pO ''' ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe:
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? �O
1
•
.._:._
•
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C .
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 permftis•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
Signed . ` " ` " a
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
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Page 3
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PLOT PLAN AND DESIGN FEATURES:
Include by measured distance location of wells, springs, potable water supply
lines, cisterns, buildings, property lines, subsoil drains, lake, water course,
stream, dry gulch and show location of proposed system by direction and distance
from dwelling or other fixed reference object, and additional submissions in
support of this application such as data, plans, specifications, statements and
commitments.
Ala �e
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170
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Page 4
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Section 5.03.01 (2) shall be amended to read as follows:
(2) Manufactured Home as the Principal Use of the Lot: A manufactured
home shall be allowed as the principal use of a lot as a use by right,
provided that each of the following conditions is satisfied:
A. The manufactured home is at least twenty four (24) feet in width
and thirty six (36) feet in length;
B. The manufactured home is installed on a permanent concrete or
masonry footer approved by the Building Official;
C. The manufactured home shall be skirted with materials of the same
appearance and color as the siding and be permanently affixed to
the building, if the foundation is not completely enclosed. The
Building Official may require tie -downs in locations subject to
high winds;
D. The manufactured home has a brick, wood, or cosmetically
equivalent exterior and have a pitched roof with no metal
materials not pre - painted with a non - metallic color and
permanently affixed to the metal by a manufacturer;
Manufactured homes as the principal use of the lot are allowed only in
the A/I, A/R/RD and R/L zone districts.