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Home My WebLink About01998 f T is ' 10 r ( GARFIELD COUNTY BUILDI!IQ AND SANITATION DEPARTMENT 109 8th Street Suite 303 Glenwood Springs, Colorado 81601 Phone „(303) 945 -6212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT NSI 1998 a building or use permit. Owner ducky S Nancy Walters System Location 0416 Meadow Lane, Westbanka Glenwood Springs Gary Helsel Licensed Installer • +� • ConditionsLConstruction approval is hereby granted for a' fj 0 O gallon �'— Septic Tank or Aerated treatment ttit. Absorption area (or dispersal area) computed as follows: . Perc rate of one inch in 8 minutes requires a minirytum of 179 sq. ft. of absorption area per bedroom. ' Therefore the no. of bedrooms x /19 sq.; ftalminimum requirement m a total of 537sq. ft. of absorption area. /2 ' X N / 4 i )(✓'' Po c. ier I- F A G I-f t3 ea May we suggest: l �� — - 24 0 ,4_ Date .7 / .- 7 2 . Inspector e+ — i I. FINAL APPROVAL OF SYSTEM: I 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. �j 0 t 0 . Septic Tank access for inspection and cl within 12” of ground surface or aerated access ports above ground I � ;wf , . surface. 1 1, ✓ Proper materials and assembly. Poi CO » 2 2 .7r .t Trade name of septic tank or aerated treatment unit: d p� i 1 6 / 0 X ' 6 Y Adequate absorption (or dispersal) area N iii 1.----.--.---- _ Adequate compliance with permit requirements. ", fi s Adequate compliance with County and State regulations /requirements. J J Other (��.� -- �,, / �( .� i Date / _ / t. I Inspector t,X ii!a_ � Y� •�'� d ;'.: in, RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE i is 'CONDITIONS: 1. All Installation must comply with all requirements of the �Colorado State Board of Health Individual Sewage Disposal Systems , Chapter 26, Article 10 C.R.S. 1973, Revised 1984. ,, ) 2 his permit Is valid only for connection to structures which have fully complied with County zoning and building i requirements. Connection to or use with any dwelling or, structures not approved by the Building and Zoning office shall autgmatically be a violation of a requirement of the p(Irmh arid cause for both legal action and revocation of the permit. 3. Any person who constructs, alters, or installs an IndIVJQual sewage disposal system In a manner which involves a knowing i and material variation from the terms orspecifications dontalned In the application of permit commits a Class 1, Petty Offense 4500.00 fine — 6 months In Jail or both.). i Applicant: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by County Official: OWNER BOCA.1 ADDRESS e ft Ci{u re (JO LO PHONE / S 3 . °L' CONTRACTOR (6A e'/ pf 6 1 � � �- l ADDRESS 13 /9 7 f, JrY Legivc PHONE 4 c 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: County t,, G their Near what City of Town 6 (-6:: AJCATVW Se, / NGS Lot Size 1 t/SGrZFS Legal Description LOT Z C2 FIc -I tu0 41 3 (JESI BH/Uk WASTES TYPE: ( (Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe _ BUILDING OR SERVICE TYPE: ___ Number of bedrooms 3 Number of persons 2-- ( ) Garbage grinder (Automatic washer (Dishwasher SOURCE AND TYPE OF WATER SUPPLY: 0.--1 ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: t1 to N g id If supplied by community water, give name or supplier: w't TBR N K e O NG1f GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 5 /YIIZ FS Was an effort made to connect to community system? eo TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (j.l'eptic Tank ( ) Aeration Plant ( ) Vault ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use ( ) Chemical Toilet ( ) Other - Describe: FINAL DISPOS L BY: ( 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? N a S07L 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 Ho._ 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 per l'.t.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 sane 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 u 2- I (992_ Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • Page 1 ' lc, t F �.�w .. c15, !t, y 'i �Sr W , ' ,? `, 4 /1iI(r a41,11 n ' � �( ti ; };'( t 4 k1 A I d a '� P I' ' Pc t',Y ''rv`vti, - •. t,,7 • `t; t, (, •.i 4,1Y .'.t . ,. 11 1441 4,1 q t s , ‘ I. � , 4 f' 't r'q i . , "Ito t FI 4 N c . 1 11111 , r ' 4i e, 1 ! i•. r N Sa Z C' • U1 �\ W 0 M ' `i, to IiiiCal m E it N i . i :T. 1i 2 '' i 'i S' " <-- ., f ' ' � f t 1 J ar y ; t t a , t g f X31 • j y 1 � t 77 y l ( si. i >1 { Q x . , N ' 1, M1 + ) 1 , ' . \ t ; t ! t } r 11 l S`. '1N' Y f i Z d ate t d, PI y v t �'• IC, o ,l , Hc, C � kg L� t f� r: � t 4 1 :i' • i