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Home My WebLink About02572 .s 9-.�., n.--- •- ..y7fl4 Y.• .lam - -.T _. . ; GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2572 • 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 Levi & Charlene Troyer Present Address P.O. Box 53, law Castle Phone 984 -3306 System Location 0651 Cedar Breaks Road, Grass Mesa Ranch, Lot 18, Rifle 5 Legal Description of Assessor's Parcel No. SYSTEM DESIGN aSt Septic Tank Capacity (gallon) Other • f /N 9 ono Percolation Rate (minutes /inch) Number of Bedrooms (or other) Required Absorption Area - See Attached Special Setback Requirements: Date 4- ip 4 . Inspector 3/4 Y c ' � i v_ '' FINAL SYSTEM INSPECTION AND APPROVAL (as installed) • Call for Inspection (24 hours notice) Before Covering Installation System Installer (s)W ') P 1 .� h 7 / .h F' e- P C' c • Septic Tank Capacity 2 l Septic Tank Manufacturer or Trade Name C a10) A )7d. Septic Tank Access within 8" of surface Absorption Area I/ CO Absorption Area Type and /or Manufacturer or Trade Name f/ t rl 4 i n fk Adequate compliance with County and State regulations/requirements ! �' Other Date 'V /' (7/74 Inspector ( - M ) 0 ( ) s.+rc RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE *CONDITIONS: 1. All Installation must comply with all requirements of the Colorado State Board of.tlealth 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 end revocation of the permit. 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which Involves a knowing end material variation from the terms or specifications contained In the application of permit commits a Claes 1, Petty Offense ($500.00 fine — 6 months In )ail or both). White - APPLICANT Yellow - DEPARTMENT 41 INDIVIDUAL SFWAGF »ISYOSAI SYSTEM APPLICATION OWNER 1 2vl e C;)l44t41e !i• 7o er ADDRESS -Pd ?o)c5 Mao Ces!l'- , CO �lb97 PHONE 981- 330 CONTRACTOR I- b v i - T m t' -e ems ✓ J1 / �J ADDRESS Po13 to( 53 t N fP I CO6'/ Y7 PIIONE O - . 3 PERMIT REQUEST FOR 94 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 Boles (See page 4). LOCATION. OF PROPOSED FACILITY COUNTY 6 r T 1 Jet Near what City or "Town_ R \ 2 __ -- _ Size of Lot II 0 {9 e c-e S Legal Description or Address_ - WASTES TYPE: ( DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Si n 012- Cam% .5aNe V eik Number of Bedrooms ;---4■•..6\AP , v — umber of Persons Garbage Grinder f/)' Automatic Washer .(/(Dishwasher SOLJRC1: AND "TYPE OF WATER SUPPLY: b4 WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: — lf supplied by Community Water, give name of supplier GROUND CONDITIONS Depth to bedrock: y Depth to first Ground Water Table �- �eer Percent Ground Slope 10 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: _ Was an effort nude to connect to community system? ( ) YES c) NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PTT 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 � WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? N N 2 ..1;k1 31,ATiON T'FST RESULTS: (To be completed by Registered Professional Engineer) Minutes per inch in hole No. 1 Minutes per inch in bole 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 fiunished 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 proposes of issuing the permit applied for herein. 1 fu 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. nr er Signed Date 3R/9 /9 (9 PLEASE DRA AN CCURATE MAP TO YOUR PROPERTY!! 191 11 D KO \ jI If ci Qi- Cam "k\\ \A i r k 44) ,1 O 3 Y)r • 0 Ca e 0 W w N N � 0 W W Al O 0 ' N A ' w W I a 1 (t: Y 1 ree7„erli w \Milo 1 f ` (C SA O) C.3 0 I -a co I _ '� I o S w 1 A y wo m '. 1 • N ( \/ m ) ° \ w N tO 1 w v I ICO . I W 1 N w N p NJ V W O A t_ A D w CO N J N 1 V D N tO N / . . I T A ° A C•3 1 0• W r- N A CO e c m 00 I p w n V , ^. IV to to 1 C 1 ca \ O N W tO N W 10 4.3 W C•3 . 11 W N S. -4 CO W CO D W 4.3 ��e N \ O CO J Ea 41. N l® O N V O N O N W Mr W N W �O4b •V bi CJ en' 327 e. / - Fa .W.. 261 ° V 4.1 NEU 1 US ,a3 w w W A j ONi J I W 1.4 N ° N I A ` I N tO W w N v J J W W I N k %.\ l 10 96 7 Sz (6 12 11 1 • 13 14 6A ' 6 2 1,4 15 16 V7 _ 5? r L 24 1 Iji 1*!IW TO COUNTY RO�i 1 26 4 25 24 Dom 3 22 27 il I •� 2B JO 31 32 •� 29 ROADS _•- r 37 36 35 344 J4 • • 1 40 JB J9 39A 44,4 1 I- 42 47 • 46 45 43 ' I 48 50 I 52 1 1 •5 1 • 49 51 6 a.• . -• 58 57 NOTES: _ . 1J WHERE R040 INTERSECTS C THE LOT LINE. 2) • INDICATES CORNER FOUND 59 3) IN MOST CASES THE LOT CORNER CAP IS STAMPED W7771 THE LOT CORNERS POSITION. 4) THIS DRAWING REPRESENTS A FIELD SEARCH 60 FOR LOT CORNERS. NO ACTUAL SURVEYING WAS y PERFORMED. SIGNS WHERE LOT LINES INTERSECT i ROADS ARE APPROXIMATE 61 i i k• GREC&ARD L ROLSAN� SITE MAP ,-i ..- -1 - nol Land Surveyor GRASS VALLEY RANCH 477J 214 Rd. RIFLE, COLORADO SIR 60144174o 1 ........ II (30.7) 876 -2947 J aim v03/95 PRGV. 95125 CR.4SS0F4V • S89'35 1322.22' LOT 18 /IT PROPOSED r POWER LINE LEGAL DESCRIPTION SE1 /4N£1/4 Ju SECTION 28, T65, R93W j OF THE 6771 P.M. .5.1 v ALSO KNOWN AS LOT 18 fl ¢ 0 CRASS MESA RANCH COUNTY OF GARF/£LD ‘40 5 7 STATE OF COLORADO SCALE ROAD ! OCR - !00 It 589'42'O5 1324.78' 1/4 CORNER • MONUMENT FOUND • SET Ec CL.S13501 IMPROVEMENT LOCATION CERTIFICATE / HEREBY CERT /FY THAT THIS IMPROVEMENT LOCATION CERTIFICATE WAS PREPARED FOR GRASS MESA LTD., THAT IT IS NOT A LAND SURVEY PLAT OR IMPROVEMENT SURVEY PLAT AND 77 PIT IT IS NOT TO BE RELIED UPON FOR THE ESTABLISHMENT OF FENCE, BUILDING, OR OCHER FUTURE IMPROVEMENT LINES. / FURTHER CERTIFY THAT THE IMPROVEMENTS ON THE ABOVE DESCRIBED PARCEL ON THIS DATE 12/ 2 1 /f5, EXCEPT UTILITY CONNECT IONS, ARE ENT /RELY WITHIN THE BOUNDARIES OF THE PARCEL, EXCEPT AS SHOWN, THAT THERE ARE NO ENCROACHMENTS UPON THE DESCRIBED PREMISES BY IMPROVEMENTS ON ANY ADJOINING PREMISES EXCEPT AS INDICATED, AND THAT THERE IS NO APPARENT EVIDENCE OR S/CN OF ANY EASEMENT CROSS /NO OR NG ANY PART OF SAID PAR L, EXCEPT AS NO ED.' O I- PS ?� R /CHARD L. HOLSAN, L.S 13501 i t LS ; S . . r . r at.. < /e11... IV • aesiva re a........ h . i .••• A .Lt s _ Du R° AD 4 ► v3-e-\\ _ y - 7 . 7\.„ . . F .E h 5 LOT IQ 1 \ € • 5; cg.- 1 '`� eart4014e S __ i J1 �1 G,v -aVe) IC iQd/1 -. _.. ja .,,s•D ., '.... • .v._ ___. .: - .� a s:t ` i ircit *X ;si its. :r__ 1 ! :.. • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 109 8111 Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 01601 Phone (303) 945 -0212 1 his does nol constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY 7 - 1 2 &) Owner's Name i-k'(5 1 4 e /- /iQ fre.e.VE- Pi csenl Address Phone System Location 6 t-s -, C-COQQ ys at legal Description of Assessor's Parcel No SYSTEM DESIGN L 6 0/71/ llisjr9S Y is -,o /1 Septic lank Capacity (gallon) Other v pi) `7 yn Percolation flale (minutes /iuch( Number of Bedrooms (or other) Required Alrsor ;Mon Ai ea - See Attached • Special Setback Ilequhemenls. Dale Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Uelore Covering Installation System Installer. Septic Tank Capacity Septic lank Manufacturer or 1 rade Name Septic Tank Access within 0" of sorface Absorption Area Absorption Area Type and/or Manufacturer or 'Irado Name - Adequate compliance with County and Slate regulal innsh egin, comets Other _ _. __ _... Dale......._.. Inspector _... RETAIN WITII RECEIPT RECORDS AT CONSIRUCRON SIZE *CONDITIONS: 1 All installation must comply wilh all requirements of the Colorado Stale Board ul I leallh Individual Sewage Disposal Systems Chapter 25, Article 10 C.R S. 1973, Revised 1904. 2. This permit is valid only for connection lo sir uclures which have IuIIy 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 n 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 manner which Involves a knowing nnl uiniri variation Irom the loons or specifications contained in the application of permit commits a Class I. Potty 01lense (.$500.00 n01' - - 0 months in jail or both). Whilc- A('PLICANT Vlllow- OLPAI11 MEN! • . 6rte,ini 7-,e0i'E-2 q 4 Al/4 _ a a V i_ a8 _ Po 1 g 9 � itfr 7 � 4 k .2 :n t"- Z i H / /0 ' Al iti5 i. 7 6 - L � oc K 4 Zc -ter A 9b //9 bv �R4s g II .6r 1 t Qo7 TdJf= iL74-dlr Zs. .5 c29 E 4 )4 /0- c/ srvc;, 9- le`tt m - &Cu- / g l / A , Ppe _ 1 IA b_ �� to �\ m J e1 t,b O