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HomeMy WebLinkAbout02887 a • T _ -_ , GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2887 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 943-.2 e n/ 7 Owner's Name Robert Holmes present Address $.O. Box 264, Snowman Phone_ 704 -0764 System Location ( 0?C7 County Road 113, Carbondale Legal Description of Assessor's Parcel No. 1) MOO [c —LEACH ^ LSeo ._a' tI56 k! SYSTEM DESIGN '2) le Pieces t.C'AcH C4A MOcsc a -� 512n 2-11 11 or T rtemCkel 4V3 N p u r� tr i L/ ' UO C7 Septic Tank Capacity (gallon) 4) �` 1 ( Other r 3 O 41 M rts 3 ` 2.2 Percolation Rate (minutes/inch) Number of Bedrooms (or other) 4 t NOTE. I f 10✓ IN STALc A GAR cSAaE Cal taoLK Required Absorption Area - See Attached Y OV tit v ST A 00 1' N 1 / 4011 - 6 P1 Cc e S ekAmistma = Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering installation System Installer 0 W /v Septic Tank Capacity r Cr) 0 Septic Tank Manufacturer or Trade Name /.1 0 C C U 1 N C Septic Tank Ac4ss within 8" of surfer Absorption Area lll' 30 v 1Y `' i' 7 ( 2 ),,.._ ,c COL' F(E S \ s � � ) / n. Absorption Area Type and /or Manufacturer or Trade Name 1 N / tcal S (\ Adequate compliance with County and State regulations/requirements / Other / 9 A 2 [ /-- Date- 1 t -t ` Inspector ' /'�(J 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 )ail or both). White - APPLICANT Yellow - DEPARTMENT JNDIVIDUAI. SEWAGE DISPOSAL. SYSTEM APPI.ICATION r - J � ra`M� ` OWNER 14 ' �' � I ADDRESS to x � � t • _ . cD ■ s , 7(554--- • CONTRACTOR P-- C t . G ?)` & '5o w ADDRESS PHONE PERMIT REQUEST FOR (O NEW INSTALLATION ( ) ALTERATION ( ) REPAIR Attaclt separate sheets or report showing entire area with respect to surrounding areas, topography of area, Habitable building, locution of potable water wells, soil percolation test holes, soil pr files in test holes (See page 4). LOCATION OF PROPOSED FACILITY; COUNTY �j Ct?l'-W�t'c Near what City or Town J Q ( , ze of Lot '4 � t t' e Legal Description or Address & et— teaMlt &•«l vInW'et -'t - r U We - < WASTES TYPE: (kr DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: � J'- 1-�✓v. I —f c� (? ` Number of Bedrooms • Number of Persons ' ) Garbage Grinder ('Automatic� �Was e bishwasher ` AND TYPE OF WATER SUPPI.Y; l�ql TELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: • /J bar Ifsupplied by Community W _• • lier Depth to bedrock: Pe- '&©i k.J " fmr `I /� t! wIL J Depth to first Ground Wat r Table e SO r t ' Sob r ,, 3 • Jt Percent Ground Slope tlr DISTANCE TO NEAREST COMMU` _ ° ° • , v�titi� M ` e Was an effort :Undo to connect to community system? ( ) YES £>4 NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ()CSEPTIC 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: ( ) 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? 10 CM 2 • 'pEItCOLA'l'ION TEST RESULTS; (To be completed by Registered Professional Engineer) Minutes per inch in hole No. 1 Minutes per inch in hole No. 3 r Minutes per inch in hole No. 2 Minutes per inch in hole No. Name, address and telephone of RPE who made soil absorptio►rtests:. . 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 mandntory and additional tests and reports ns may be required by the local health department to be made and finished 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 nmde, 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 ire 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 a plicntion and in legal action for perjury as provided by law. I /01 Signed • I Date PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! See_ Jac-Leg ncetti° • 1 LA) m CWeet--) Po .e.se9 out)._ 6c.it •9v.O.Qw (0 1 '---'� b b kJ-) b--7 • J e 1 • l_ `V ,n �• ..J VJ 14 i'IU.VVO r.UL • '124'1 eSeat',ocll aratd. ( Wa L evt, _ , " ;.I ,t , I3ogialernd Land Burveyore {j \ (1t All (nlorndo Avenue `CSI/ Glenwood Springs, Colorado 81001 • 003) 00.8004 t,'•: 1'.• • a PROPERTY DESCRIPTION • A TRACT OP RAND SITuATYlO IN LOT S or SZOTION 1, Ton:SHIP 7 9011711; RANOS 87 NEST OP T�I6 SINTR P.N., GARFIELD COUNTY, COLORADO, SAID TRACT OP LAND DEMO NOM PARTICULARLY D SCRIBED A9 POLLONS; OBOINNINO AT A POINT ON 2711? EAST 1.1118 OP SAID 1.07 9 n0,1'1,71108 TM NORTHEAST CORNER OP SAID Lox DBAR8 H.00•1*'18 "W, A DISTANCE OP 201.04 FEET, SAID NnNTIPABT CORNER DNINO NONUNNNTED WITH A AND PLASTIC CAP Pitt S. 18817; TURN C0NT1NVII0 ALONG SAID BAST LINE 8.00.28'10 "E ,1011.87 P357 TV MS SOriTDRABT CORNER OP .4411, Ayr R. SAID SOUTHEAST CORNER DUNG NO1711M NTED WITH A ROAR AND PLASTIC CAP • 1.1.. 8. I014r; TIIRN ALONG T11R SOUr!IRRLY LINE or SAID LO7 8 8. 00.111'07 "N. A D1trANCR OP 1880:37 PRRr m 7118 murmur COHNRR 0P MID LOT t, SAID SOUTIm'ROT CORNER BEING A RESAR AMT) merle CAP P.L.3 13817; MIN ALONG T118 NEST 1111E OP RAID LOT 8 N, • 00'0.1'92 "N. A DISTANCE OP 1090.00 MT TIC THE CENTERI.INR OP AN B,YIBTING COUNTY ROAD; MEN AtO O SAW CENTRRLIHB N.18•18'08 "B. A A;tSrANCR OP 01.70 FER7; ram DEI`AR71NO PAID CENTNNLINn 8.87•28'01"E. A DISTANCR OP 1811.27 FEET TO r118 POINT OF BEGINNING. SAID TRACT OP LAND CONTAINS 80.000 ACR8R As DBSCJIIBED. DEARINGB AS RECITED IN 11118 DESCRIPTION ARE BASED UPON A BEARING OF N. DD"l7'27 "IC POI( hill SUUW LINE OP SAID 1.07 a. NORM:POTATION 851N0 FOUND IN rift PIBLO AR DESCRIBED IN rim DESCRIPTION. THIS DPS(:RIrTION HAS DEM PRITP410YD 8• sANUBL 0, P118LPs, COLORADO RSO, I'ROPBSSIONAL LAND SURVEYOR taunts, FOR AND ON BEINLP OP SCARROW AND WALKER, INC. jA i • 41 ' r �• • , APR 25 '113 18147 PROPOSED IIOLMES RESIDENCE Io COTIUNWOOD Pnss ADJACENT TO COUNTY ROAD 113 GARFIELD COUNTY, COLORADO COUNTY ROAD 113 CATTLE CREEK ROAD To GLENWOOD SITE A l t SPRINGS N NO SCALE HIGHWAY 82 N TO ASPEN b • ' VICINITY MAP 1 1 ��' j3 (,�c-�zJ g citto -- gym .l 3r- � _ .. • o a (4 1 ,cr. ' E 2 ® e4 P P . 2 2 440. v 4, 1 1 -5 J 11- -- ____ —. (olJ 1 ' 4 - 1 06 , ----->" ei .�• � • A S AP / OXIMAT E326ILDING ENVELOPE u it 1 `f7 34:lc& (p 1 3 44 'Y 1,,y, F \vi M 0.14P . ,-i PROPERTY BOUNDARY 9 APPROXIMATE LOCATIONS OF EXPLORATORY BORINGS Job No. GS -1848C Fig. 1