The URL can be used to link to this page

Home My WebLink About02119 4 ar • it GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N= 2119 f 109 8th Street Suite 303 Assessor's Parcel No. n Glenwood Springs, Colorado 81601 $ Phone (303) 945.8212 j This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY t Owner's Name M. M. Richard 6 Carols aarreeuu 700 W. Sth Rifle Phone 625-3024 . BantSr & ddress System Location County Road 320, Rifle i Legal Description of Assessor's Parcel No. SYSTEM DESIGN ' ii 1 „ .0 0 Septic Tank Capacity (gallon) Other Percolation Rate (minutes /inch) Number of Bedrooms (or other) S Q4 /O `/5 r-7' /? <r -6- /. &44,6 o.f - / k ' X 4 s�,' f : , d J -1 1. r r„ Required Absorption Area - Seb M 17 , „ Special Setback Requirements: 9 S - y '- F7 ' c r ,t t ere 3 S 7 f . t , < ,_, r , s Date Ce— P n Inspector `. 4-.- FINAL SYSTEM INSPECTION AND APPROVAL (as installed) ' Call for Inspection (24 hours notice) Before Covering Installation 4 45 System Installer 0,44,..--1.- 4 Septic Tank Capacity / 5-0 d Septic Tank Manufacturer or Trade Name t , ,o- f p 4r«.. el tl S Septic Tank Access within 8" of surface 1.--- tt n 1 / Absorption Area 9 S L' " `4- 1n., -- ) /y C r / f� ..4 — ! ... /rn--t 65 I 7 t. Absorption Area Type and /or Manufacturer or Trade Name T .^ �f l - c - t - U Adequate compliance with County and State regulations /requirements /. Other 1/ n Date 7 "/ — 7 3 Inspector Ej")-' ( ,4- U'-e-t'I-Q- 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 office shall automatically be a violation or a i p + 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 s variation from the terms or specifications contained In the application of permit commits a Class I, Petty Offense (5500.00 fine — 8 f months in )all or both). - -Y- Applicant: Green Copy Department: Pink Copy i Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by n County Official: OWNER dl!,n H. & D,)(r.. H. tBnrneff ADDRESS T 21)4 5t1, PNONE 1 ( :ONTRACTOR___ 54t/YLC______ ADDRESS _ PII0NE_ 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 Lest holes, soil profiles in test holes. (See page 4.) LOCATION OF PROPOSED FACILITY: County G r- Fir.(rt Flear what City of Town ie. Lot Size /0 Ot Q/ Legal Description alfaa/LLCvl _ WASTES TYPE: ( X) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: (lumber of bedrooms d / Number of persons 5 ( ) Garbage grinder (XC) Automatic washer (X) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( )() well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: brN6415 If supplied by community water, give name or supplier: N A GROUND CONDITIONS: / Depth to bedrock: C�'V , _ Depth to first Ground Water Table: a//t6/ k2-0 P. Percent ground slope: Its/ A4a -- (�o . / DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 7 /piles Was an effort made to connect to community system? 4 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (X) 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: (jC) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: _/iVF /G7MA? WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF TIIE STATE? /1/I® , • Pane 2 ;OIL 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.__ lame, address and telephone of RPE who made soil absorption tests: lance, 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 pernift,is subject to such terns and conditions as deemed necessary to insure compliance with rules and regulations edopted 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 Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY Lk) c L-> E ' 1 ` /\ X _ X 1 1 I llwy De L 320 Pc1 f 1 I r- . ) on Mc DUn4101 S otD Red (a set,..r wok,. F- 7.0 mile.' 320 - Roo.d Page 3 • suo 833 PAcE739 EXHIBIT "A" A part of the Southeast One- Quarter of the Northeast One- Quarter (SEyNE4) of Section 27, Township 6 South, Range 94 West of the 6th Principal Meridian, more particularly described as follows: Beginning at a point whence the Northwest corner of the Southeast One- Quarter of the Northeast One- Quarter of Section 27, Township 6 South, Range 94 West of the 6th P.M. bears North 1 ° 04'59" West 388.24 feet; thence North 85 ° 24'23" East 1299.92 feet to the center of a 30 foot road easement; thence leaving said centerline of easement South 0 °55'I1" East 388.07 feet; thence North 89 ° 44'40" West 1296.73 feet to the subdivision line; thence following said subdivision line North 1 °04'59" West 278.16 feet to the Point of Beginning. TOGETHER with a 30 foot non - exclusive road easement for purposes on ingress and egress to and from subject property to County Road No. 320, being 15 feet in width on either side of the following described centerline: Beginning at a point whence the Northeast corner of the Southeast One- Quarter of the Northeast One- Quarter of said Section 27 bears North 5 ° 15'16" East 279.00 feet; thence South 87 East 1281.82 feet; thence following a curve to the right 58.24 feet whose radius is 68.92 feet and whose long chord is South 63 °45'38" East 56.53 feet to the centerline of the existing County road, the point of terminus. /off. - 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, clry 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 conni talents . otor0.d o. K ,/� =Slaht t ` I J�r —� • • \ 1:4 IO acres 18 d� a �., P Sass Den ■ I 0 1 acres • X well ■ • • 1 I I � ' 1 i , \ I IOQe CZ, G S 10aCrtc e • 1 I 320 l Page 4 TYPE OF SYSTEM TO BE CONSTRUCTED Sly to ;" C1ean n ess Otfierwise Approved) TOP TOP 4" perforated V o�° o o o °P %' o • 0. o Gravel mgth deter- _ - - , pipe b o oon a ° o p 000 0 0� s a e . riled from p 0 9,0 ° POo O o ° °0 rc test " ‚ 4" solid pipe b oo °O O O a ° p suits r f rom tank °040 ° ° ° o � � " w00 00 4" solid pipe ex- ^ --- * o p 0 o `�-- tending into ^" ti ' ` oa °oo drywell 1' r. tie po ° oo O0 00 Q O,. , . , . � . ! , , . , � s traw over rock p000n E °o OQO c, 0 0 CA O o CO 0� p co 0 qa�° OO pQ000"00 40 �� ci . v O a p1 q O rpne O 0 ° =0f nP`�* O M O p 00 Sao co oo OOQO p 3' 1 6' 1 3' *Size determined from perc test results SIDE VIEW Backfill SIDE VIEW ckfill ;, Backfill i )00KYXXXkkX or straw 4" solid pipe to tan' p8 c� c.S` y °io 2" gravel over tip`% Cone , f 4" hay or straw Par a �c o.z+. 4" pipe in `ii$ . F �: 1 , c4i.ye � gravel T. �� Gravel Ocaa o °0 6,400000" (C� . ' Tr, c 0c , 0bp o o a .a: 6" Gravel * ,, 4 . Concrete rings or b p p°D � 1O q�oog' under pipe '' Op 0 ot� � U �� cinder blocks vu�a l 4 1' of gravel in , lip I bottom Seepage Bed «3 Drywell n ri Other — ^` y (FOP Arm TrANTC TrarnorenTTr'N1