HomeMy WebLinkAbout02036 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N_ 20 3 6 1
109 8th Street Suite 303 A is Parcel No.
Glenwood Springs, Colorado 81801 2393 - 141 - - 006
Phone (303) 945 -8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
PROPERTY
Owner's Name Doug & Sharon Leslie Present Address Virginia Phone
System Location 0317 Sage Swale Road, Pinyon Peaks, Carbondale i
Legal Description of Assessor's Parcel No. 4 .
SYSTEM DESIGN +
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other) 3
Required Absorption Area - See Attached +
Special Setback Requirements:
Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity `, ti U 0 p'
S
Septic Tank Manufacturer or Trade Name u ' L ' CI
Septic Tank Access within 8" of surface 1^^
r7 L.7 f p7666
Absorption Area / e t
Absorption Area Type and /or Manufacturer or Trade Name notf° ■ r' " 1 C;.*N<- . ✓' l
Adequate compliance with County and State regulations/requirements (---
Other.
Date > ' rt rr ' / ; Inspector "r "/
RETAIN WITH RECEIPT RECORDS AT 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. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning off ice shall automatically be a violation or 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 jail or both),
Applicant: Green Copy Department: Pink Copy
Application
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
' 1 County Official:
OWNER' BUG, « Sgetters LE6 ! 61,00
ADDRESS Vig6)10/4 PHONE (Pe Lo •
lt
CONTRACTOR_ D, fl .l�cw &Lc_
l G �
ADDRESS p, a, 3 A G PHONE %3 -P
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 c-4 -p
Near what City of Town cA2e (KO At_e Lot Size 5,5 .4G,
Legal Description_ I�s2' C, 1 ppui&J (0'8 --A' S Su6OI i.1I
WASTES TYPE: ( t� welling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: lQ€ 2i0(54 __
Number of bedrooms -j Number of persons G.
( Garbage grinder (tomatic washer ( 1.4-
SOURCE AND TYPE OF WATER SUPPLY: ( t� ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: Y(l /srve
If supplied by community water, give name or supplier: f'/ 'J`(dxJ t
GROUND CONDITIONS:
Depth to bedrock: ^'lam _
Depth to first Ground Water Table: (4'1K
Percent ground slope: 17.
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:__ /N/L -
Was an effort made to connect to community system? J
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( 4Septic 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:
( y :'1bsOrption 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? A/'
Paae 2
SUIT. PLYiCOLATION 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 2. per inch in hole No,406-
Name, address and telephone of RPE who made soil absorption tests: DAvlo A-, " . ' C-f
/ O,3nc &,3i 963 -C1867
Name, address and telephone of RPE responsible for design of the system: Ddc)io
/ vC3 C -6 ?(62. c743
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 nude 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 niy 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 le/u/-lL Signed .,5% ,w2-64-(
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
•
Page 3
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.
Page 4
� / ;
/ v / /
■
/ r.
•
v ?R t
..: / tar
t ,
." , _.„...,,........."-- , 1 . , ): it ' (4 ` :
+' I
"'' ;,1.'748 '' ! •. • 48
r ' ' t
�� f
•
•
•
r ls lr✓" 4.... / #
•
vi
/ c i f ,
0
1 i i ,
r 7f ,
•
.1 (
f9 . itti al ,
.t .
•
•
\ a 4 r �� fir; 'I . 14
n
1
,. . :1k , .
,"...:.:"., : l \ N. 1 \ i n
1s t u•I 1
\ �
24.01 1.01 114e411”10% 114e411”10% w.r \ ' `
M.N 1 0 1 1.0 107 107 • t 411.22 411.22
M.N 04.68 108•411•11n 84.7/ ,
,•••• ,•••• • nM'1t1 211.116 ,�
iJ W.0 .0 01111 01111 tr.w \ I \
[ ' 1 . • ' \\ N.M 841084.27.1 r. ' • r 1 ,, 4 I
N.., IN.N 11.0 120.01 120.01 � 11.42 «.0 •^ ♦ "r � - . 1 } 1 �f,
0.0 41.27 W114.211111'8 11.01 �. � { ,
42.84 u•.w tr• u•N•r 184.48 7
42.27 N.M SIT Oren NMI
` •• - \\ 1 • ) 1 � '
nun .48.84 pFK•Int an S
y A 7
i f 1 84 � 1 »H V .\ ^ . 70 t n• I1•0 070 J a 84 Nor Win NM \ �� 11 11027 /',' 1 1 MN .7•4 84.04 rF110•0 24.78 24.78 O 11 MM Mr NI0e 1111.80 ( l ` W. .0 1 \
14. 14 27.84 011084 n.12 s,
[ ,y
01.10 O74.It WI' 0•0'• 18 .r
70.48 11.84 1110.11111101. M0.04 01.10 01.10 04.17 WY 1111•011 04.10 '•
:1.
1100 N 1140 mi. N'M'0 )LM
NAt MI .711 nor 01'0 N.O i
84.0 10.44 1110 IN.Ot
'004 y \ > � I
0 OWN en ••
0400 0. M n 44.00 y
0 1784 nanny 4240
0,1 71.28 fern' Inv 71.0
1 1 84.00 Ma•O/' sr. r so. 71
A , '�
41.42 11.84 Mon $ N' 1 0. 20 v ■ ` •. � ',
24.0 47.0 Mtn11 41. 11 •
\
0. 11 tin 14 /'1 4840
10. tinware 1 1 4 .0 4 •' � /
0,0 110.0 le )4 • ICI 100.N
. �'
424
14 00 117.17 10'84'0'1 114.00
14.0 1 \
11.07 I1n *
14.11 41.0 NFil'el't 41.11 ` �
14.11 48.0 • 4
n o*.o '0 7 .11
84.84 171. • 0 • 27/1'41'[ 111.11
r.7* 11. 0 1727M'N't 11.1) \ , \
00.7* 00.7* 10.14 / net •,•• 111.84
.
71.00 , 11.a 1 111.42 •
114 .O1
• 00.01 MF N • N'e 111.01 ' `: +'
0.84 10.84 1427 M '17'M •. i1 S
41.03 0.48 JI}14.01•• 10.54 14. 0 1N .a NY42•M•• 1'1.84 •.�
•0.84 12.10 / FM'IP) 11.48 '
•
` , �\ \\ ,,.\\\\.\\ `�
•
/ P.\•.vFn I0'. / /
� G 1 T q �
a � J 25 Alf
v, / i/ if
et
/
■
/ .....e.
1
• •
•
' Irl `
•
1 1.
1] \ 1 �^
1
Q
7
j 14r ,k ti / •
i N. � � +C , i
__......• il 7:
" 1
1) i
i t • ` M5 \ t
\ (
• 1 r
1. 1
\ , \:, r
•
\ 1 1
1 = 5T . .. . _
1 1. 14 0 10.11 re Wen 14.0
.04 411.99 1440 11901411119014111 » -
.tr1 0.
14 94.14 4.14 NM* a•It•t n.»
M 10 - ` '
.03 07.03 0.0317 4003 \
M ''2 .
01 111.17 19.19 1011•17'17 101.101.114 '• 1. \ `q\
11 00.14 03.03 1003 14 Y7' • 14.10
M 29.0 10 » ,.0410 »
».4 M 113140 f 11'1131401111110 4.1 ».n ' +,
M .00 1 .4 •'•[ 1 .11
.00 40.49 71.10 9 0.11 \ 1, 1.
4 71.0 10.11 97tn'11 110.17 t to WI
•
14» 03 ` 4 + . 01 •
00 ..10 W 00 u.» I7 1 ,
00 10.15 •1.17 03.031)2 •1.17 '• • ` t
• 14.11 0'a
00 9.17 14
IMAM 0•41 110.1 . /'•.. \\
911
00 44.17 . 17111111'14 17111111'14 1 17.17
1.. �ntl'•e4 41.50 \
••• a \` f
31 1 ;, i 3
e. 03.0 011 10.6) 14 01 S OS. 1
e• 09.02 10.0 nl•» 01 70 \
!J 01.00 71.00 1 0'57'10'5 »J 0
0 ✓ �.
71 40.07 03.0, MIrn'17t 1.03
• 1 10 r \ .
.10 110.54 100 111.52 `J \
71 13.54 ROAN 10r 11'171 9.71 • ((03 1
. 70 54.73 03.21 1112•34'1101 9.14 Q
00 6\0 1
21.71 57.00 0r 11' 01 1 07.0
CO 53.10 , 0 3 03 612 1011•52•471•104.19110•11011•52•471•11 104.104.191101011•52•471•11 •1011•52•471•11 11.10 , \ \ ` \
00 74.33 1013'' 72.4 ' L [
00 1.10 104.11 031)1' 05 14.10
• 47 too 31.07 41•03'1'• 11.10
47 1.02 90.79 MI•31'01•• 03.111 \ \ 1.
CO 03.0 10.40 /14.17'11 134.10
M 101. 110.00 111r4'03•1 207. N
03 N 031
02 41.21 .05 0'01'' 03.05 �,11 \ \ 1 .
O 0 02.09 57.50 M 1.31' 40.20 `V2 7 \'
70 31. 71 74.02 MM• 11•30•• 71.9
75 4.11 97.30 114r 00' .w 11." e \
57 11.07 21.00 031•31'31•• 0.50
07 00.15 03.01 140' '• 111'01•• 11.42 ■ \
07 20.57 07.50 312•14'01 0•.03 ,>,\
117 34 7e 10.10 1,0'11'14 4.4
79 01.11 110.75 1•1'0041 10603
70 11.0 117.17 100•30'10 14.10
01 4.41 41 0 1411•72'11'1 47.07
4 11.11 40.11 1143•19 41.11
'0 120.10 171.0, 10'11'172 147.•1 •'\
02 30.1 4.03 07rn 71.11
05 10.72 111.•1 1 0 14.3 \
11 57.31 111.41 02°3.1'07'1 111.40 \
11 111.01 21.01 531•111'50 1
09 157 10.112 Sir er07• 1.71 I. - `
CO 1600 0000 71117•11'011•11 9.11 ` -
10 04 57 113.45 lir4'00'11 100.11 •
I• •5 4, 1.6.76 5 1.77'11'2 71,40 _.
•
IIN
mre/3c/9).
cy a e o 0 s Alfriet
-e el tide
_
1 1.04" /OE? 7
• 4.••••■
tiZt y‘d01:41 -
s-
:1:411 1 2 I "ha k 7_14 (9 6P)
I L !
3 4.0-orr. I _74. e Late"
0:24 7 ,,G(.944,:) •r-- CIS 0
s-730
3_c_7
. _
Tr!