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Home My WebLink About02537 • CANFIELD COUNTY L1UILI /ING AND SAN!TAIION DEPA FITMENT Perin11 2, 3 7 101) MS Street Suhe 303 Assessor's Parcel No. Glenwood Springs, Colorado 0101)1 Phone (303) 945.0212 11is floes roll atnslaulo INDIVIDUAL SEWAGE DISPOSAL PE OMIT a building 01 use penal) PIIOPEDTY Linda Craviett 0407 CR 261, Silt 876 -2358 Ownor's IJanm I'1uuunl Ad d. too; Phone Syshrrl 1 onoh0.1 4678 County Road 301, Parachute 1 oval 1)osurlotion of Aesu::::ui 1':;111 No SYS I EM DESIGN bra Septic 1 Cnpncily (gallon) 011ie, le irl 1 6' k'k',nmmobml Ilain (minolestiu.Ii) Number of Bedrooms (w into') gsfl i a& 4 tc ior- 8N.., 4Do d'P $ L freul e-Pe/' 9o7 U flequimd Ahsol pliuu A.0„ - Soo Allnchurl 4,5v4 T Remelt xitiP ', 1 f0f- ay „ $ /07ifito %Ere% ash a-1t- Spe(:IaI Setback Iluquilumuuls' Dnlo / / % / y'/ 7 11 — �� bu:pnc lur Y�1/✓> L - ' ^p -' �'! FINAL SYSIEM INSPECTION AND APPROVAL. (as installed) 1 ... _.. 1111 .. _...__.__.... .._ Gall for Inspocliln (24 hours n iolicco) 1101010 Cuvolinq Installation P System Installer EIQw- ( ace /N Seplli; -limit Co /0od 1111 /1 Septic tank Iveuulm:tulu or Lade: 1101110 eap-14z.10 • Sophc land( Accuse�s ffwi II" of 5111101:11 ye Also) /111011 Anm Vt9 d Te(g,UC —f• Absorption A1a typo nod /110 NlonolucIUr:r u. hide Damn 1 Ir .oa v / L7RATenS A11.01 Adequolo compliance will) County and Slide m(ul(llnnshoqu1IImonls Other .. . • lu Dale V . 7/'I/'.� � lSi r:puctm ' / .lP�j2Q i , .... 5 TIE(AIN WIIII FIGCFIPI IIEC0111)S Al cow, nuclION SIIE. • *CONDITIONS: I. All inslnllnlion nulsl comply with all ioquilomenls ui l he Colorado Slate board of l luolll, Individual Sowago Disposal Systems Chaplo, 25. Article 10 C.fI.S. 1973. flovisod 1911-1 2 I his per mil is valid only log contraction 10 sae octoros which Imvu hilly complied will] County zoning trod building 1orp11rumonls. Cum noellon to 01 usa will. any dwelling or snucluros non approved by Iho 11ulI(1Ing HMI Zoning ollico shall amomolically boo vlolallon or a requirement of the (Prune and cause 101 both legal 0011011 and rovor,olion of the per nil. ( 3. Any parson who conshucls, allots, or 110011115 tea lndividualsowegt disposal sysloni in a mmnnor which involves 0 knowing 011(1 motel al variation 110111 Ilm dal1115 01 spocilicaliois comainod 111 Iho appiicalion 01 permit commits a Class I, Polly Of loose ($500 00 Ilia -- 6 months In )ail 01' hmh). While - AI'PI ICAllt Yellow • Nld'AI l l ldl. - li f 7 6", 7 S s / o zo 8 8 71 S fZ alb P $ z _ 8 ( so .4 a . /b 7 a / 4 rN /4 I/'V IS-4 a edge 4 L F9za Sap g b p c>26 � A 0_ 04 9 0 7 4 4 N.A4 7 , AK!t / 7 /uft /L g o? 47 O— a( - Fie° SPA" o z4 04 L C e 5 oI GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2537 109 8th 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 Linda Graviett ,, 0407 CR 261, Silt 876 -2358 Owner's Name Present Address Phone_ County Road 301, Morrisiania Mesa, Parachute System Location Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer_ Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and /or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other Date Inspector 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 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 L ac INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER L114 ADDRESS 6 'T n 7 PHONE 7 76 - x,35 E' CONTRACTOR A/¢,e C�eva441 ■ ADDRESS 03 d'*/ /d s een 1 ce- PHONE 0 27 , 3 - 5' 77 x' 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 test holes, soil profiles in test holes (See page 4). / LOCATION OF PROPOSED FACILITY: COUNTY (�Ax•FiE c e Near what City or'fmvn y _e_a/F S.4 Size of Lot O - Legal Description or Address s. P, 9S!✓ . /n, // - Y/„d «x , r- E ' /a JJC A SA , � o t . N� na T p Coe ,so/ WASTES TYPE: (X) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) 0111ER - DESCRIBE BUILDING OR SERVICE TYPE: //Ou sic Mae a . Number of Bedrooms Number of Persons �- ( X) Garbage Grinder ( A Automatic Washer (X) Dishwasher SOURCE AND TYPE OF WATER SUPPLY; (a') WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of' all wells within 180 feet of system: tie/ 4 ,7 If supplied by Community Water, give name of supplier GROUND CONDITIONS: Depth to bedrock:_ Depth to first Ground Water Table Percent Ground Slope DISTANCE 1'0 NEAREST COMMUNITY SEWER. SYSTEM: Was an effort made to connect to community system? ( ) YES (Y) NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( SEPTIC TANK ( ) AERATION PLANT ( ) VAULT • ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE FINAL DISP AL BY: ( krABSORPTION TRENCI I, BED OR PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE / WILL EFFLUENT BE DISCIIARGED DIRECTLY INTO WATERS OF THE STATE? /I4 2 it 6 PI ?RCOLA1'1ON TEST RESULTS: (To be completed by kegistered 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 proposes 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 ivies 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 proposes 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. Signed��.o�c� U� Date /tal- 9r.< PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3