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Home My WebLink About02094 ` .t.._ • .- y�f . C t ' GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit IVs, i 2 O 9 ' 109 9th Street Suite 903 Assessor's Parcel No. a A Glenwood Springs, Colorado 91901 Phone (303) 945-6212 I l This does not constitute , INDIVIDUAL SEWAGE DISPOSAL PERMIT . a building or use permit. I f PROPERTY . ( Owner's Name Shane & Bruce Limited Present Address 6876 Highway 82, Glenwood ! _. 945 -0147 9 System Location e 7/ k.. (JOUR) 6 ,S7 , 6 /P/N wee de 5 K i . ., Legal Description of Assessor's Parcel No. 4 p� s SYSTEM DESIGN 1 1 eptic Tank Capacity (gallon) Other -i 0 Qa radna 6 - / J Percolation Rate (minutes/inch) Number of itaiiKor othA'r)" i Required Absorption Area - See Attached 43,„ T 2 0 r f a r X /2 r t r n Special Setback Requirements: 50 r p•Rapt f� o W.) (;�R R t O i7 ,Q . � Date ' .. i Inspector / riled/ fc"✓ i ' FINAL SYSTEM INSPECTION AND APPROVAL (as installed) i, Call for Inspection (24 hours notice) Before Covering Installation 1 a System Installer Septic Tank Capacity loan /p� Septic Tank Manufacturer or Trade Name (.4 O G+t'1/r/L� 4 Septic Tank Access within 8" of surface f g r h rf Absorption Area ,/7o # ## Absorption Area Type and /or Manufacturer or Trade Name 1 4 4- 7/4-7r. / I Adequate compliance with County and State regulations /requirements 7 k 3 t , / I Other 2 / Date S 4.'94- Inspector - =- lr iLL /. ! a - , L RETAIN WITH RECEIPT RECORDS AT CONS t UCTION SITE *CONDITIONS: �� •- F ' _ 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Dja(osal Systems Chapter 25, Article 10 C.R.S. 1973, Revised 1984. d , 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 e 1 requirement of the permit and cause for both legal salon 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 T. variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine —8 3 t months in jail or both). Applicant: Green Copy Department: Pink Copy Application / 01 ; INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by (/ County OJNER '5t4/gJ k ✓e& tArti ty Official: '/y 1 Co ADDRESS GA:. SyZ wz,.4IG 45500 1711747 filt+ �PIIONE J0511V t CONTRACTOR_ $TTfolA7�sts/L Ala/e -CA dry ADDRESS (ad gulf 92--- PHONE sue' PERMIT REQUEST FOR: New Installation ( ) Alteration ( ) Repair Attach separate shee 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 6-24, j e./d Near what Ci ty of Town 6 ad( IfIoo.l Lot Si ze_O. s,qc ae Legal Description WASTES TYPE: ( ) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes (),41 Other - Describe Q f'Gvr' /Ipfv9 BUILDING OR SERVICE TYPE: Number of bedrooms it/4 Number of persons G (NA) Garbage grinder (,/4- Automatic washer 0#1," Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) well (X) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 3 $ / .2t . If supplied by community water, give name or supplier: /1//a- GROUND CONDITIONS: Depth to bedrock: ()et kel Pawn — Depth to first Ground Water Table: 1.14 kn()Wn Percent ground slope: "'tA t DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 35 ,vJI s Was an effort made to connect to community system? 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: (7) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCIHARGED DIRECTLY INTO WATERS OF TiIE STATE? III v from 7 0, Y O #+ PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) r Minutes per inch in hole No. 1 Minutes per inch in hole No. Minutes per inch in hole No. 2 Minutes per inch in hole No._ nie, address and telephone of RPE who made soil absorption tests: me, address and telephone of RPE responsible for design of the system: iplicant acknowledges that the completeness of the application is conditional upon such irther mandatory and additional tests and reports as may be required by the local health apartment to be made and furnished by the applicant or by the local health department for irposes of the evaluation of the application; and the issuance of the permit is subject to ich terms and conditions as deemed necessary to insure compliance with rules and regulations 'opted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies let all statements made, information and reports submitted herewith and required to be 1bmitted by the applicant are or will be represented to be true and correct to the best f my knowledge and belief and are designed to be relied on by the local department of health n evaluating the same for purposes of issuing the permit applied for herein. I further under - tand that any falsification or misrepresentation may result in the denial of the application r revocation of any permit granted based upon said application and in legal action for per - ury as provided by law. ate /ffer X90 a�� Signed _,.ri /r LEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY I Page 3 Q 4_ z5 �/� /mod or XJ,Z / r -. 1 . - _ A mus J01 GO POPIAT#f +l 9y," w a division of TJ,i of A,ijonal t,,'.{�pp'� rw °+" LL ,,.i .: , ' ' PACIFIC INLAND OP@ ' • - WESTERN SLOPE SALE Ic '' ' " � 1 "` 201 Centennial Street • $ ,$ 100 • Glenwood Springs CP , 1 ii' / r 7.9C) , it %; \i' , , 1 fti , ' t // 1 . f • i JOB NAME: JOB # LOCATION: SHEET OF _ SALESMAN: BY DATE: ___ --