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Home My WebLink About02668 - . .rte r GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 26U 8 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 I This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Lisa Krudenier • (d Joe Scofield present Address 5355 CR 100, Carbondale Phone 962 � - ! ' 72 Owner's Name ,:- Pi% System Location s3 47 County Road 100, Carbondale Legal Description of Ass sor's Parcel No. - '•, ` SYSTEM DESIGN ) 7 S D Septic Tank Capacity (gallon) Other H I 1 • / a _ ffl.4 Rate (minut/inch) Number of Bedrooms (or other) (�y ,;Z ✓ .3V R f temze 8t1 t _ 9r 44a ctd6/ - 3 !" Required Absorption Area - See Attached - r _ ?�4 /AIflT /02 Special Setback Requirements: 4..680 D' 1FaStEWP is vnof r s Date q - 4 to Inspector /flan FINAL SY AND APPROVAL (as installed) Call for Inspection (,4 hours notice) Before Covering Installation 6 I-( ('ONs/. System Installer_ /('`�� Septic Tank Capacity / 00 0 C 0 p < t A nr 0 Septic Tank Manufacturer or Trade Name / Septic Tank Access within 6" of surface `7 / _ Absorption Area y G 3 G Absorption Area Type and /or Manufacturer or Trade Name 1 1P 1 , L 7 A 4 Adequate compliance with County and State regulations /requirements Other Date 1 -''L 7 y l (h Inspector A I-/Vt 'IS 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 1, Petty Offense ($500.00 fine —6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT -i ' • INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER ._ _ JO - 6 (O21 i-e / --) 6A VRu1De-1J)e -g- ADDRESS 5355 C&WM 7 100 CARS PHONE CONTRACTOR F , d-t CSE (01471i ADDRESS t74 visi ni P1S74 RD CAiZB. PHONE% -- 9 PERMIT REQUEST FOR y 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: Near what City of Town rAtizecogioActe Size of Lot 10± ArtR 5 Legal Description or Address 53G CCOMY it 0 I00 WASTES TYPE: ( )C) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: 144Z/4 W I TI-k AP. RTME\T A nJS Number of Bedrooms 1 Number of Persons 2 (?Q Garbage Grinder Automatic Washer V4 Dishwasher SOl TRCE AND TYPE OF WATER SI TPPLY: () WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: 14A DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 3+ M tLeS ? Was an effort made to connect to the Community System? rtl7 A site plan is required to be submitted that indicates the following MINIMUM distances: Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOIJT A SITE PLAN. GRO! TND CONDITIONS Depth to first Ground Water Table WW/ *k' ( (i 2 F' - r /'0 Percent Ground Slope b 7o k'-- 2 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ^rte• (X' 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: (>4 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? IN.D PERCOLATION TEST RES! JLTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) 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 purposed 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 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 b. ed upon said application and i -gal action for perjury as provided by law. J $ Sign-. i Date —1 -% PLEA' /RAW AN ACCURATE MAY TO YOUR PROPERTY! 3 . i ® , • go \ (/ \ # / / Cl. t \ T n �� ! _ { go r % \ co 0 PD \ 2 a $ 0 z \ ƒ§ 0 \� / C co 5 ; # % �» , (" / &0 ) { 2 775ƒ \ wee \ \ \ . ,/ \ _ 07 ? . fl to-' �E� � . \ \ /��` z - 2 �\ /� ( w $ 3p �� 3. PO 4 x ƒ \ / ST z � 6.1 C--- i 2@ R. o > oo C v) � 9- ,74c - tar '27 /ICJ k42 UDEA)I 60 : 3 2 �" � 3 fit 3 )10. /4- 6 a/ s �) T = - - No s al /A 7 / ")N 1.2 /)/4f spz, p a 31 n blocK LE.2 dIF ,8 En A00 0 -?o o (sifilpd rig-doe -- Mir{- Q /o?t VA) '7s 1 vE " /- Y lal4J"D2s 21µk- /(2, 1 Arers e FFvSs �r' 9-3--.-94.. agdb _ g/b 3om. /54t'Y!!-?Nibz � al z- ai a�, �y t a7 +�a i n 5 g a 8 l a N a 7 il big ; aI f, X AN /„7 nmo S eaa it ReCK 4 t64 -N L3 F- -- cL. Ap4 ac,` Fo R. a14P sore imste.sii_4---a_sh. 4SB' i u LNF,z 7-/z1 T6(2_ .e) ,., 17-5- /S #sB gl0 L,rFv5sts /$ /2aaa it/d C e /Fic m ■ te. r3ox6 - _ __, S3 = J f0 w ,aL A ABak % saa 'Reek 1 Lem e _4 __ W r .,cN 1Z UMTS TtiPi` a1n e , /.S uNtA -1111 ., riEw • h. l 1 • . , GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Perini( 109 01h Street Suite 303 Assessors Parcel No. Glenwood Springs, Colorado 01601 Phone (303) 945 -0212 I his does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit PROPERTY Owner's Name L / KF•4S/Ol&P— Present Addinss 1110110 • System Location_ Legal Description of Assessor's Parcel No -- - SYSTEM DESIGN 7sP Septic lank Capacity (gallon) 01 r J / A' ,E'o c*y+ • 0,1 4.,ZB/n I'ercolalioo Rale (minutes /inch) Number of Berlroums (or other) Required Absorption Area - See Allached Special Setback Requirements: Dale _... _. InspcGbr - FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Belore Covering Installation System Installer. Septic lank Capacity... Septic Tank Manul eclat' or trade Name - Septic lank Access within 0" of surface Absorption Area Absorption Area Type and /or Manufacturer or trade Name Adequate compliance with County and Stale requfalionshequiremmms - Other __. Dale_ _— _...._ -. -. Inspector -. FlETAIN WITH RECEIPT RECORDS Al CONSTRUCT ION 511E *CONDITIONS: 1 All installation must comply with all requirements of the( :nloindo Stale Board of l lnallh Individual Sewage Disposal Systems Chapter 25, Article 10 C.R.S. 1973, Revised 1904. 2. This permit is valid only for connection to Slrucluros which have lolly complied will' Counly zoning and building requirements. Con- nection to or use with any dwelling or slruClur not approved by pre Building and Zoning of Iice shall automatically be a violalion or a requirement of the permit and cause for both legal aclimr and revocation of the permit. 3. Any person who co nstr ucls, alters. or installs an individual sewage disposal system in 0 mannei which involves a knowing and materiel variation Iron the terms er specilicalirxrs cnnlnined in the application of penntl commits n Glass I. Polly Of Tense ($500. lien - 6 months In jail or both). White APPLICANT \'ultuv• DEPART mull