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HomeMy WebLinkAbout02516 rW 11R e4�'• rr" �R' A! vPSl r „ y r N”. }.�:Pi.+Y�'�'''7ISi'�S�DT 1 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 516 109 13th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Don & Bernadette Reinarz 6025 CR 233, Silt 876 -2601 Owner's Name resent Address Phone 7z8-'7 /Z5 System Location County Road 110, 6.Ir1L+alialle Cho NU.ao Legal Description of Assessor's Parcel No. 0 f \. SYSTEM DESIGN rn, ? ..v„ c��.° � 1r ��� / k-? �r tar'''. l GL .� � c 6 00 V // Septic Tank Capacity (gallon) Other /jnttill .2,9 C� Mr Percolation Rate (minutes/inch) Number of Bedrooms (or other) 3 1 - V N�r Ft' �rK.rt fr .4 eacA f try l2, Xl/ j I X caP Rd A4soretioy Ares gee Atl hed _ $ 3 7 R ' 1 rrRX"er one. / 1 Special Setback // Requirements: 5 et-gym c �'t . ' � ^''"' IDa(e 13 _ )w Via... t i. ,: lnSl C(Or err/ . ' ./ -e -m-4. FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer_ OWAISe Septic Tank Capacity /SOO h'9L Septic Tank Manufacturer or Trade Name ` npt Nc Septic Access within 8" of surface yes Absorpt Area � x 7a I X 3 -.See 4'ar /4/94 f 4-GWF /64'/1/ 0 Absorption Area Type and /or Manufacturer or Trade NameleOO L A7c - # /'D –2A'P6 Adequate compliance with County and State regulations /requirementsye Other OX 7 CO S ,� ( I -- d Date / Inspector CP 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 — 6 months in Jail or both). White - APPLICANT Yellow - DEPARTMENT • 1 . . • INDIVIDUALSRWAGE12ISPnsAI, SYS_TEM_APPI,ICATION OWNER - Da nl a T3 c_e►.34a17t=ne [2a\ Aez ADDRESS (,o75 Z33 Q,nAO, `J \l.'( Co PHONE g1A -2601 CONTRACTOR ADDRESS PHONE PERMIT REQUEST FOR (✓rNEW 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). LQCATION_?I? PROPQSEDjACILITY: _ COUNTY A ar u Near what City orTownn CLar�sWc,oD SPaIW(1S Lot L-- r 2 Legal Description Wrt1I -o )r OtVlstota1 WASTES "TYPE: ■welling ( ) Transient Use ( ) Commercial or Industrial ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: I - 3' DC.14 11 al_ Number of bedrooms: Number of persons 2 - ( )'Garbage Grinder (--)'Automatic Washer ('Dishwasher SOURCE_AND TYPE OLWATJ}ILSUPPL_Y_: () WELL (X) SPRING () STREAM OR CREEK Give depth of all wells within IHO feet of system: ^r/a If supplied by communiiy water, give name of supplier: YES Ho f r gt\ p ALIt'N 1r t.I a ?S t ,S c_, GROUNI?.QONDITIONS: Depth to bedrock: >k t t1/-1`.1 10 Depth to first Ground Water Table: hd Percent Grbiind Slope: 15 7. DISTA NEAREST COMMUNITY SEWER SYSTEM: 10 �IL.S Was an effort made to connect to community system? Nn TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (LT 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 Filler ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCI !ARCED DIRT ?CI'LY INTO WATERS OF THE STATE? No L',tiItCQLA174N_LI ST_RESuLTS: (To he completed by Registered Professional Engineer) . Minutes per inch in hole No. I Minutes per inch in 1 -tole No. 3 Minutes per inch in hole No. 2 Minutes per inch in 1 - Tole 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 appliction 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 inusre compliance with riles and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies that all statements make, 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 bre relied on by the local department of health in evluating the sane fro purposes of issuing the permit applied for herein. 1 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. i _ Signed L_ . Date lo.l( PLEAS ILDaAI_ANACCURATILMAP_TC1 Yn111LP_l1nl'_I IITY xip p, 'V :% CAt3Le 6frC\ r d i • PLOT PI .AMANLL DESIGN..E 3ATt HIES Include by measured distance location of wells, springs, potable water supply lines, cisterns, buildings, property lines, subsoil drains, lake, watercourse, 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. ‘ . 42.5 l o \let_.. r 6do5 / 2 7 � � / ' `3,F�oF 1�.t*Lc- I - U Pm, eciest t'{oLe.s / 6 0 - -- 4410 , I .- -- ___ _ .__:. " - // 641 G4►6 4 I I tZo ' 1 . I HepworthPawlak Geotech TEL:333- 945 -8454 Jul 21 95 11:17 No.002 P.02 • ^. Hlil'N'Ult'1'H•1'AWLAK C:li(1'1'Ii(111NICA1. INC. Snxn Rood 1M Civil vnal tips i'i s, ((1 $141II 1 ac V/11 $454 Phony 9711945-79M July 21, 1995 Don Reinarz 6025 233 Road Silt, Colorado 81652 Job No. 195 345 ` HOLE NO. HOLE DEPTH LENGTH OF WATER DEPTH WATER DEPTH DROP IN AVERAGE (INCHES) INTERVAL AT START OF AT END OF WATER PERCOLATION (MIN) INTERVAL INTERVAL LEVEL RATE (INCHES) (INCHES) (INCHES) (MIN. /INCH) P -1 47 10 19.5 15.6 4 16.6 13 2.6 13 11 2 11 9 2 9 7.5 1.6 7.5 6 1.5 7 P•2 48 10 22 16.5 5.6 16,5 13 3.6 13 11 2 11 8.5 2.6 - 6.5 7 1.6 7 6.5 1.5 7 P•3 45 10 24.5 18.5 6 16.5 14.5 4 14.5 11 3.5 11 8.5 2.5 8.6 8.25 2.26 - 8 9R - 4.25 _ 2 fi 04.4.ttdn /9 ^ Note: Percolation holes dug by client were 8 to 10 inches in diameter and soaked on July 19, one 1996. The percolation tests were conducted by H -P Geotech on July 20, 1995. 3e /1 4 T AGREEMENT REGARDING ISDS PERMIT WHEREAS, Don Reinarz (hereinafter "Owner") has applied for an Individual sewage disposal system (ISDS) for a house to be located on lot 5 in a subdivision known as the Westhoff Subdivision, on County Road 110, Garfield County, Colorado and, WHEREAS, the Garfield County Building and Planning Department normally does not issue ISDS permits without a building permit for a residential structure being issued at the same time;and WHEREAS, the Owner and Building & Planning Department agree that there was a misunderstanding regarding the County's policy regarding the issuance of ISDS permits at the same time as a building permit; and WHEREAS, the Owner is willing to make certain assurances and agreements related to the Issuance of an ISDS permit prior to the issuance of a building permit and on the basis of such assurances the County is willing to issue an ISDS permit . NOW, THEREFORE, it is agreed as follows: A. The Owner agrees that no residential dwellings, temporary or permanent, will be placed or built on the property known as Lot 5 of the Westhoff Subdivision, prior to the approval of a building permit application for any such structure by the Garfield County Building & Planning Department. B. The Owner agrees that the approval of the ISDS permit does not entitle the Owner to use the ISD system for any purpose, until said building permits are approved for the use. C. The Owner agrees that any change in plans requiring the size of the ISD system to be enlarged will require the issuance of an additional ISDS permit, at the fee or costs in place at the time of the issuance of the additional permit. D. This agreement is binding upon the heirs, successors in title, and assigns of the parties. County of Garfield, Colorado By: By: C-- C 1litni ems^ 2 Don Owens, Chief Building Official Date: /0 ?:- Date: P-1' -7 h