The URL can be used to link to this page

Home My WebLink About02215 ..+sv.w ...+r -. yi• in.•.: r.rN - •- rw.�ra.r.. •:..ten n+•,w"rw A.-wv .r.* �� ...... ... .. .. ryy{ • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N. 221 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81801 Phone (303) 945-8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY 9z9 3- 33yA Owner's Name Orlea & Robin Dove Present Address 5387 CR 154, 083, G.S. Phone_ 40-6921 System Location 0698 East Vista Drive, Masuohi Exemption, Silt Legal Description of Assessor's Parcel No. ' SYSTEM DESIGN /. 7' ( r Septic Tank Capacity (gallon) Other w,, 1 { Percolation Rate (minutes /inch) Number of Bedrooms (or other) f y 1.' r r: 1 II r e - A 4. A C,Ne Pi ( c Required Absorption Area •See Attached �' ' , � i i t rr `,.., i / nh , - l^,e'.. Spec Setback Requirements: o ey n p ' y �^�, ,� ( 1 A, fn-‘.. .2 r/ f? r Le ip Date -i -' / li " '7// Inspector 4 J r'7' i (C'4 /C At A FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer '1 ' i _' _/ Al 1 Septic Tank Capacity P • f Septic Tank Manufacturer or Trade Name /'." l- i f • (� �.�rr•�A c � ��Ji^`-� ��' 1 Septic Tank Access within 8" of surface 1-"" .°.----- � ( l I J �(, c l.,n i. Absorption Area s l / ' ", Absorption Area Type and /or Manufacturer or Trade Name I - �1 " Adequate compliance with County and State regulations /requirements / - 1- Other Date ? ... / /r. • 7 if Inspector C ir. i --- ,en-1 4.4,4) ay) - 11.2 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 i 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 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 Jell or both). Applicant Application INDIVIDUAL SEWAGE DISPOSAL SYS11.11 AI'PLICAI ION Approval by County Official: OWNER i.e.. J /. .ldr ADDRESS PRONE f3- 3fr CONTRACTOR <croix _ -- ADDRESS PHONE PERMIT (REQUEST FOR: (7) 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 Lest holes. (See page 4.) LOCATION OF PROPOSED FACILITY: County Near what City of Town S e r ________ _ _•_ — _• _Lot Si ze2j7_Q. _, S Legal Uescriptlon_� //y - .3 —. C•Si - GJ_e_ T i WASTES TYPE: (X) UwelI1 ( ) Transient Use ( ) Commercial or Institutional ( ) lion- domestic Wastes ( ) Other - Describe ----- - -` Ji- --- _ — __ - -- — BUILDING OR SERVICE TYPE: 1 ,.„ --,22, n 7X4p7F' ^ _ — — (lumber of bedrooms ,3 — -- (lumber of persons ( ) Garbage grinder (X) Automatic washer ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ,( well ( ) spring ( ) stream or creek Give depth of all wells within 1110 feet of If supplied by community water, give name or supplier: __ - _ _ — ____ _ — __— GROUND CONDITIONS: Depth to bedrock: - - -- - -- — -4 -- — Depth to first Ground Water Table: ------ _---- __ — T . � --- - I'ercen t ground slope: _ .----------------------------- DISTAIICE 10 NEAREST COMI1UNI1Y SEWER SYSIEM: _ Was an effort made to connect to community system? TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYS1EM PROPOSED: (i1') Septic Tank ( ) Aeration Plant ( ) Vault ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration toilet ( ) Iecycling, other use ( ) Chemical Toilet ( ) Other - Describe: __ — _ ; _ _ FINAL DISPOSAL BY: (x) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Saud F i l t e r ( ) Above Ground Dispersal ( ) Wastewater fond ( ) Other - Describe: - -- --_ - -- _ -- WILL EFFLUENT BE DISCHARGED UIItECILY INFO WATERS OF 111E SiAiE? — c • • Ploy 2 . . ,5010 1EST RESULTS: (To be completed by Registered Professional Engineer.) • Ilinules per inch in hole No. 1 Minutes _per inch in hole No. 3 • Minutes • per inch in hole Flo. 2 Minutes per inch in hole tlo._ Flame, address and telephone of RI'E who made soil absorption tests: _ Name, address and telephone of fl'E responsible for design of Lhe 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 periiift,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 same for purposes of issuing the permit applied for herein. 1 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 IIAl' 10 YOUR I'ROI'ERTY • • • • • • • • • Page 3