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Home My WebLink About02379 ...r.�.��NP�:- •..oy; . ,.... z....a ,c,r,,, +mm.v�^.'. F?'° pn^ Mwdvf"A14,'.'+F:-:rN,9'v]^Y^r�F ...r,,. s...yy:.o:;ry ^a*ya... .rre r .: v a r.F � , . i. — V. a ., _. i f GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N .. 2 3 7 9 109 8th Street Suite 303 11 Assessor's Parcel No. Glenwood Springs, Colorado 81601 IN Phone (903) 945-8212 Al This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. it PROPERTY It Owner's Name William & Nancy Sabel Present Address Box 3938' "Pans CO Phone_ 399 -5111 1 . i System Location 0 4 7 / County Road 311, Silt k Legal Description of Assessor's Parcel No. d a � V SYSTEM DESIGN � , 1 try Septic Tank Capacity (gallon) Other (('' b 1 OP a Lion Or 3 • It / (1 2,111 percolatioo A are (minutes/inch) Number of Bedrooms (or other) 9 1" Pit lie Required Absorption Area - See Attached ? a Pent-ic $ C F / ' 124 6 5i telt g 6 I�oi= '�+iLF'.v)If'Mt7Dl�'. as•S. c re ,a, p� s . , Special Setback Requirements: a ts!/ NI a ,. Der. et•. VS Cie. 3 ~S. a F 1 i Date /r - /""b•t In j.sj. E`� ev . FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation it System Installer t 3 4' fl C t F >i rilke ' ' Septic Tank Capacity ), 7J CO Septic Tank Manufacturer or Trade Name n4111.44-41Q.— I d Septic Tank Access within 8" of surface L 1t S g Absorption Area rfi l }r (} Absorption Area Type and /or Manufacturer or Trade Name VS- f jJ E' i6 7t ?47 /5 ■C S .%r' / f L' - + • �r Adequate compliance with County and State regulations /requirements trC' S 1 Other l'i: Date j- S - Gki' Inspector c � . l /i 4,... C / -! RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE F *CONDITIONS: 1. All installation must comply with all requirements ofthu 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 — 6 months in )ail or both). i, Applicant: Green Copy Department: Pink Copy S 1 • : . Application JNDIVIDI TAT . SEWAGE DISPOSAT. SYSTEM APPT,CATION• • Approval By � ipinty Official /Y OWNER //� /A , l K ,r%4'C t-4S4 - / c o t e ADDRESS for 9, Secr /o 765 "'we 92 it or*Avy �Y / e -5 -5 PHONE 399-s7// CONTRACTOR /ar/E Cfr Y //+ ADDRESS BO ( .3 6 2- 4% C9 S t t 2 . 84 4/7 PHONEk 2 air 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). J.00CATION OF PROPOSED) FACILITY : County c.4/R`c -Z Size a? y crL�S Near what City or Town Sic r- Lot r Legal Description 20 t 9, S& r /0 T OS /69/Ycer 92 /r 6 rid f / WASTES TYPE : (✓j Dwelling () Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Number of persons 2 Number of bedrooms (4 Garbage grinder (✓j Automatic Washer (4 Dishwasher ,40i JRCE AND TYPE OF WATER ST JPPT .Y; (4 well () spring () stream or creek Give depth of all wells within 180 feet of system: N/ If supplied by community water, give name of supplier: (:ROT 1ND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: — 1 Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM Was an effort made to connect to community system? TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (4 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: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: ND WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? — ........ .. ..." i ,• 0 ;.`!xtUr ;`'fir h ' 7 _ ". It i -a t[.f t l'. !: 1' • ,SOIT. PERCOT,ATION TEST REST IT,TS: (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. _ { 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 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 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. I further understand 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 perjury as provided by law. � Date /i //4/9� Signed i�//G�c..n. pT .EASE DRAW AN ACC.! IRATE MAP TO YOI IR PROPERTY 'To w "' 01/ sax I— 7O peo,JTAas A'O Q 44 4/✓EdC. S493 J6cr P/lUpE.QTy b (SA M /L ■ ago iltY Hollow RD. An is s C/4EE /c RO , N ^` pr ,OT PI AN AND DESIGN FEATI IR F 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. ■ 6 Le-c. Ad att-d-4 (IMPORTANT MESSAGE) FOR A.M. OATS 7 2 TIME P.M. OF PHONE O � e v - ' Af3 AREA CODE \ NU E�R EXTENSION U FAX O MOBILE �- . -...-- AR CO NUMBER TIME TO CALL TELEPHONED ��. PLEASE CALL CAME TO SEE YOU ' WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR • L - SPECIAL ATTENTION MESSAGE ' .' uaca /� elcr Rs t OF rim d F Or sole C A / y 9 ye� -7 H /C- ` : IGNED eft O/' / /� p TOPS t LRI IN 1 218 • - " a PERCOLATION TRST R BSI li.TS: (To be completed by Registered Professional Engineer) Minutes per inch in hole No. 1 Minutes - per inch in I Iole No. 3 Minutes per inch in hole No. 2 Minutes per inch in Hole No. _ ame, address and telephone of RPE who made soil absorption tests• ame, 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 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 corri t 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. I further understand 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 perjury as provided by law. �/ / Date // / / �� 9 `7 1 Signed i%�/� �/ PLEASE DRAW AN ACCURATE MAP TO YO IR PROPERTY -TemAiVidate- SILT I j— 70 _ •" Q -(;1' 2e 1 Peo,Ir4aC ./2D' • 2 'I ...M 4 fa i?rvete I „ er A .h.et c.„iakZT Sy906cT -�'i y,, 1 e p/tUPE+c Tr b 3/ / -- 44 - 04 f.� _ t hOSro /LC_t S, //Ah ** Cep 33 / Ce Si/ — AtyowzoW Dir /O6 tannic ,QD N /N.