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Home My WebLink About02879 ti'n vl"rr'+^ rfDg4 crrf ;nrCE "j - reVFrri, w3?F P 177 r y ; n T ; ,: .s ' `' , GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 8 1 9 109 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 John Reeves Pr Address 0225 S . Oak Wa y, G .S. Phone_ 945 -6701 System Location 0225 S. Oak Way, Oak Meadows Subdivision, Filing 1, 10, 11, 12, & 13 Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) 5 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 0 U, N C A_ Septic Tank Capacity F X t S T f N (• (13 T ii rJ K 5 Septic Tank Manufacturer or Trade Name t y' ( C7 / jJ Septic Tank Access within 8" of surface C S /^ Absorption Area S 7 3x V ? - Absorption Area Type and /or Manufacturer or Trade Name ( /g F 1 �" T (tAA ? o f'1 C Adequate compliance with County and State regulations /requirements Fr c(= Nf t fr1L- C• fit A X A Other. Date ( 0 -- 1 - c f") Inspector RETAIN WITH RECEIPT RECORDS A 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 )ail or both). White - APPLICANT Yellow - DEPARTMENT - twin DIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by County Official: .JNER Z1„1, Rvevcs DRESS 0227 5 . Pict. l� )a PHONE 147, (olo l DRtSS PHONE EMIT REQUEST FOR: ( ) New Installation (x) Alteration (X) Repair Lath separate sheets or report showing entire area with respect' t_o surrounding areas, oography of area, habitable building, location of potable water wells, soil percolation st holes, soil profiles in test holes. (See page 4.) CATION OF PROPOSED FACILITY: County c 4.e_ple - Lp 3r what City of Town 62, ew' , wc 51PRul/1/44 Lot Size gal Description fAcMeAAnins Sv6Dwtsli>LI }- 1L./A/& 1 i 1 --d'TS I O 1 I l 2 c nc( l . 1 - 0 + AL Ac = - 32 .4-6 a- STES TYPE: ( >C'') Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes • ( ) Other - Describe ILDING OR SERVICE TYPE: gesID ersGE nber of bedrooms 5 Number of persons /0 Garbage grinder (1- 'Automatic washer ( dishwasher URCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek ve depth of all wells within 180 feet of system: tart plied by community water, give name or supplier: Cpi eocas Wafe OUND CONDITIONS: O MS c-O pth to bedrock: oth to first Ground Water Table: > F, 1 scent ground slope: 5 't. 15 ° lo STANCE TO NEAREST COMMUNITY SEWER SYSTEM: 4ppgn-c. '/z »iIL.. s an effort made to connect to community system? nro PE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (t/5 Septic Tank ( ) Aeration Plant ( ) Vault ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use ( ) Chemical Toilet ( ) Other - Describe: NAL DISPOSAL BY: ( ✓)' Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: _L . BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? j✓O 3T RESULTS: (To be completed by Registered Professional Engineer.) per inch in hole No. 1 Minutes per inch in hole No. 3 ‘es per inch in hole No. 2 Minutes per inch in hole No.__ e and telephone of RPE who made soil absorption tests: / II e, address and telephone of RPE responsible for design of the system: TAN, Fll 11,1�A. l nury \n• iN I , /7 �o��p licant acknowledges that the completeness of the application is conditional upon such ther mandatory and additional tests and reports as may be required by the local health artment to be made and furnished by the applicant or by the local health department for poses of the evaluation of the application; and the issuance of the permit is'subject to h terms and conditions as deemed necessary to insure compliance with rules and regulations pted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies t all statements made, information and reports submitted herewith and required to be 1mitted by the applicant are or will be represented to be true and correct to the best my knowledge and belief and are designed to be relied on by the local department of health evaluating the same for purposes of issuing the permit applied for herein. I further under - nd that any falsification or misrepresentation may result in the denial of the application revocation of any permit granted based upon said application and in legal action for per - 'y as provided by law. e Signed :F DRAW AND ACCURATE MAP TO YOUR PROPERTY v meow Dg.+M) /AJ + Page 3