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HomeMy WebLinkAbout02749 . -.Ns- owrz +4 . -,, TriF ",^*- :- `i�kkYi*'.:ucr•..��+' x'nS. 1 , , , i+ u9: e; ,, c to 'A _x(27 , 77 . 0 7F t ,6 -�^. .. V k .7� ( '"W �' 'r ' JJJ `^ W. �Y � V 1 Z 4'Y . 7 x � I l r / GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2749 / 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 Tim & Kathi Cramer P.O. Box 23, Rifle 625 -3136 Owner's Name Present Address Phone_ System Location 7393 County Road 233, Silt Legal Description of Assessor's Parcel No. (Loc11. c.CACF( ce a 11 rt SYSTEM DESIGN INFr- r itNtOtS on 8E0 LlGd It 100 61 D o P' F V S Ert S \ 7'2EMCKtS ''Sc1 if Septic Tank Capacity (gallon) Other ^ If M to 3 I (7 Percolation Rate (minutes/inch) Number of Bedrooms (or other) PIE a 5 Required Absorption Area • See Attached Special Setback Requirements: Date 4 - 4 o Inspector A FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer 0 w K L K Septic Tank Capacity 12 S 0 M Septic Tank Manufacturer or Trade Name C O r ' t c A It V Septic Tank Access within 8' of surface /� Absorption Area - I 1 0 I T 2 / II r /r Absorption Area Type and /or Manufacturer or Trade Name 1 hl r r �- f r `A r V A f Adequate compliance with County and State regulations /requirements Other / . ry 9 1 Date L4 - Z "1 _ [ r Inspector /A- ^"'`'c 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 violatipn 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 — 8 months in jail or both). -) i White - APPLICANT Yellow - DEPARTMENT . INDIVIDI Al. I SEWAGE DISPOSAL SYSTEM APPLICATION »NER <0 (l zp 1 C(/. Cv ADDRESS PO. y 2 3 PHONE 625 3 CONTRACTOR ,S P F� ADDRESS PHONE PERMIT REQUEST FOR ().<) 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 = iz- of Lo IZ 1 Legal Description or Address — ( %' 23 3 WASTES TYPE DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: r P1i Number of Bedrooms 3 Number of Persons Z. ( ) Garbage Grinder (k Automatic Washer (X) Dishwasher SOIJRCE AND TYPE OF WATER SIJPPLY: ›ef WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: l I GJ ✓w I I cS Was an effort made to connect to the Community System? 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 Y 'IR O INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED \' UT A SITE PLAN. GK.iiJND CONDITIONS: Depth to first Ground Water Table 0v +r, i Zo -Pt Percent Ground Slope 3 -ta 2 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (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: (XI ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER - DESCRIBE kb WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? PERCOLATION TEST REST TITS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) 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 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 based upon said application and in legal action for perjury as provided by law. l 1/ Signed .,. Date 3 //> /Q/7 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 A _ § /\ 4 \ � • — 2 _ ! . Qz L % CA CO 1/ — a_ L c t \ ./ 3 $ 3 \ � ta 1 v-.< _ ba m o ct �£ °9 9� a Q. ty '')A1).14 <� \ 0 k \ 2 / \{ \ `�� ' 2 \ \ § • } = \(o 0 e 2 ©- DOS • \ \ (\ - • . "7", -0` � t • j \ \ ` O \ / j f A at y \ o • - 2 / / — I \ /\ \ o laEi 4 4 5 } C \ @2 N ) '46 COUNTY OF GARFIELD - BUILDING DEPARTMENT CORRECTION NOTICE 109 8th St. Suite 303 Glenwood Springs, Colorado Phone 945 -8212 Job located at 7 3 / - 253 Permit No. 21 c f e t s PrtC r'o-t' 1 have this day Inspected this std+Stwil nd these premises and found the following correcti needed: N (CC JO le d yr )to v tv (C f e - Nt (� e 0 A- K o r k C L C CgAri —ovt • -- T�� r=r. Fito(1/4A T AK K i S D•G, 1 L L -n(G W era ovEcc llr You are hereby notified that the above correction must be Inspected before covering. When correctlon(s) have been made, call for Inspection. gate €-( -tiq 19 on A (1-r Building Inspector Phone 9464212 w , _. .aa � h P SLOPE BACKFILL AWAY d CONE SECTION OR 24 FLAT SLAB TOP MIN /\ � j d e 4.5' MIN. \� A. STANDARD RISER d SECTION(S) / CR4N D PERFORATED RISER ; °.) 3 t IIIIPI SECTIONS) : ° ,1° . , e ° • ° e ° 5.5' MIN. e1. . a ° e. e •° • _ • °• s • — e �O 0‘46•• • • 12" - 4' MIN. 4' MIN. — 13' MIN. 11.1 NOTE: 1, PRECAST MANHOLE SECTIONS TO MEET ASTM C -478 2. BACKFILL EXCAVATION AROUND STRUCTURE WITH COMPACTED 1 -1/2" CRUSHED STONE, TO TOP Of PERFORATED SECTIONS. PRECAST CONCRETE DRY WELL N.T.S. a F104-1 COUNTRY B4G1INEERING, INC. 923 COOPER AVENUE ca_ENWOOD SPRINGS, CO 81601 94004.35 /M9\ nAC_41127C 11 /0 /QA 5 _ et N N PO 11 II Ln I si C; x n in K c n S �' S 1 -- i r it ..• f 1 I ' 03 ---- ____ T o - r � ft 4 .