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HomeMy WebLinkAbout02564 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2564 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 Owner's Name Kathy D Weiss present Address 1609 CR 112 Carbondale phone 963 -1780 System Location 1609 County Road 112, Carbondale Legal Description of Assessor's Parcel No. SYSTEM DESIGN /a S U 644- Septic Tank Capacity (gallon) Other a Percolation Rate (minutes /inch) .v'nber of - • •oms (or other) 4 6441exE-4 e i rnee - , ao$ pF/1 . ' /ST 605 Required Absorption Area - See Attached Special Setback Requirements: g '....--C., / $ /Or7 - Date V - /7 -r` Inspector - _ - 2 E,, 'a et? e 4 f' 4104Ul. n FINAL SYSTEM INSPECTION AND APPROVAL (as installed) / #NC II T N u ('j Ivl f it u te5 Call for Inspection (24 hours notice) Before Covering Installation System Installer n o2A /S ExoAaAn,v y -/9 -f6' /z tied L,,.e$ mom & ry r74# - oK ,3-Ake Septic Tank Capacity / .L, Septic Tank Manufacturer or Trade Name C- '' Septic Tank Access within 8" of surface y-ea-- 0"(r Absorption Area .2 6 bC. Absorption Area Type and /or Manufacturer or Trade Name r-� Li 1 Adequate re 4 compliance with County and State regulations /requirements r` �J (5t � •- �/ 3 � Other / 1/1-3 .-3 C / C/r o�/, ✓ Date — 7 Tra- Inspector ew- ✓�.-1a RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE C •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 Ina 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 ($500.00 fine months in Jail or both). White - APPLICANT Yellow - DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER c'j L . 1)_ t s S ADDRESS Y ' I Y P TONE 750 CONTRACTOR t r ne rol e r$ ADDRESS m v 17 67 nta, t e PHONE 1 3- 13 b PERMIT REQUEST FOR (4EW 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 1 rofiles in test holes (See page 4). LOCATION OF PROPOSED FACILITY: COUNTY H e tie lo( Near what City or Town C / , L t � q le 9 Size of Lot / 1O4 6 i t'7 o,e ►'r S Legal Description or Address 1 [ 0 q Zo ti n G / / ' z WASTES TYPE: ( IcliWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING Olt SERVICE TYPE: a.✓n, i� R . $ ; d c ' t Number of Bedrooms y 6 _ eetrpo✓h l _ Number of Persons 3 ( ter Garbage Grinder (✓)Automatic Washer (✓Dishwasher SOURCE AND TYPE OF WATER SIJPPI,Y• (y4WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: If supplied by Community Water, give name of supplier GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table Percent Ground Slope DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? ( ) YES ( ) NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (V(S'EPT1C TANK ( ) AERATION PLANT ( ) VAULT ( ) VAIJI:F 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 , p WILL EFFLUENT BE DISCIIARGED DIRECTLY INTO WATERS OF THE STATE? /V Q 2 .PERCOLATION 'ITS'!' RESULTS; (To be completed by Registered Professional Engineer) Minutes per inch in hole No. I 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 oldie permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under Article 1 0, 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 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_ i ■ Date T c h_ ii /9 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! ( a�‘,vt 4 y i(ok [ I2.. t i ___:__7 ._._ Cj j '-----______________, Seflte r 4 h 3 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 6 4 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945-8212 This does not constitute INDIVIDUAL. SEWAGE DISPOSAL PERMIT I a building or use permit. PROPERTY Owner's Name Kathy D Weiss Present Address 1609 CR 112 Carbondale Phone 963 -1780 System Location 1609 County Road 112, Carbondale Legal Description of Assessor's Parcel No. SYSTEM DESIGN "..wm✓M /a-s Septic Tank Capacity (gallon) Other Percolation Rate (minutes /inch) Number of Bedrooms (or other) _ 4 64 r e'Semine..e -44)..702 to 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 Of tense ($500.00 Iine — 6 months In )ail or both). White - APPLICANT Yellow - DEPARTMENT Witte- Z Cs' y io-,6 z ys O 6,� w S * of 1 t / /s3 cif z..33/84 ©ivA7a OAP 4 Z. 33 3° = /0 B X X 2.33 lice //U /0y /4l /,/UTlS TIMBERLINE ENGINEERING STRUCTURAL/CIVIL ENGINEERING • CONTRACTING ♦ C1BR'TiUPI E+IID ENERGY DESIGN PROFESSIONAL May 14, 1996 Garfield County Building Department 109 8th Street, Suite 303 Glenwood Springs, CO 81601 Attn: Don Owens Re: Percolation Tests Weiss Residence Permit # SBoc Carbondale, Colorado 81623 Dear Don: On May 8 and May 10, 1996, percolation testing was performed at the above location. Three holes , spaced approximately 20 to 50 feet apart and 3 feet deep were observed. The holes were dug using a backhoe and test holes were created at the bottom with a shovel. The holes were filled with water within 24 hours prior to the test and were refilled with water again approximately 45 minutes prior to testing. Hole #1 Hole #2 Hole #3 min. fall min fall min fall 20 .375 20 .500 60 1.25 20 500 20 500 00 0 00 nn 0.'175 10, 1 60, :25 avg= 46 min /inch avg= 40 min/inch avg= 48 min/inch Total average was 44 minutes per inch. No groundwater or bedrock was encountered in the profile hole. If you have any questions regarding this report please call us at 970 - 963 -9869. Sincerely, . pE s . e��,. pQ � 4.y � David A. Powell, PE Reg. No. 25851 j4'�tt�r�� /OM.. E DAVID POWEL L, P2. PHONE / FAX P.C. BOX 631 CARBONDALEB, CO. 81623 (970) 963 -9869 i4, Z cActot 4 33' Aoo4 &44 he ?ch 13-ed 46 tt t AY' X 'h • 5-4 C»' l ll�` e-v^ 2 01 X 7°' Ajr 0";:c1 per c_ty effi.