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., • " GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2993
N. 109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81601
P (303) 945-8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
PROPERTY Wolof �1 1 1 1 , L(1 ? �(v CD 1
o 6 S -
Owner's Name Sf wtlr e t •kc �t Present Address 3 LA W at- T ` 4F. lit C
' f e A n 7 •
System Location .....r- C. Yt 1 r •' � _-. , '� t O-A� -c Co . KI(035 ,
Legal Descripti � de' ! Assessor's Parcel No.
— SEC C NGn. 2-1- LEac.- CFriliu06 -c
SYSTEM DESIGN <
0 O Septic Tank Capacity (gallon) Other
h 2
1
.2 — Percolat Rate (minutes /inch) Number of Bedrooms (or other) 3
Required Absorption Areas-S \Attached
1 t
Special Setback Requirements: 1
Date Inspector
!'
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer - `..
Septic Tank Capacity I Z- S 0 -
Septic Tank Manufacturer or Trade Name C OAE C 4 NO
Septic Tank Access within 8" of su/ ace 't S
Absorption Area 1 1 ? K tztcrc N F:S OF 'S' -5- tilt.. r7S F A
) Absorption Area Type and /or Manufacturer or Trade Name 1 N ifs � L. A- T/ 7 OM_ J ( 2 r X d' r
Adequate compliance with County and State regulations/requirements
Other
Date ' •••• t 7 —9
Si Inspector 4 Ct F-r
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must complywith 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 — 8
months in jail or both).
White - APPLICANT Yellow - DEPARTMENT
T
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATTION
OWNER • ..944 � / / ' 6Ar �// � p
ADDRES 596 �[�}y�_ /2 Z C�/J1 J PHONE 97 - /�l0
CONTRACTOR ZS a�17Y:GYy. x, /�.4',//1/r
P �2D-98 ( S . :7
ADDRES / �/ . i i - i PHONE l /f3 — �/� TS
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).
J.00ATION OF PROPOSED FA H .ITY;
Near what City of Town ?A 4 A C} -w(ir Size of Lot /3 3 s 5e PT
Legal Description or Address 4 yte/an4 i 4t4Jf/ .YJa/7 /WZvD/i/
WASTES TYPE: yi DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE / ,
BUILDING OR SERVICE TYPE: /224f 2 /4M< n
Number of Bedrooms . e3 Number of Persons c=-
( ) Garbage Grinder Automatic Washer ( ) Dishwasher
SOURCE E. AND TYPE OF WATER mPLY: >4 WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: 4/4
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: NA
Was an effort made to connect to the Community System? Y0 F,1-J.xnc Or" ; ra
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 ISSIJED
WITHOUT A SITE PLAN,
GROT ND CONDITIONS; �/
Depth to first Ground Water Table /�P
Percent Ground Slope a Fnet #c F/vndred (sa..n, lq deaanAM tfyor -)
2
r
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
74 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:
( )) ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION
(e} UNDERGROUND DISPERSAL ( ) SAND FILTER
/( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER - DESCRIBE ////��
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? 40
pF.RCOT.ATION TEST REST iT ,11 (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 oer inch in hole NO. _
Ni fiddrgss and telenhone of RPE who mad oil absorption tests._ ? _ / - _y _
--y - r
Name, address and telephone of - E — responsible for design of the;,ystem � - >
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.
Signed 14.. Date 4 //t/i
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
JAN -23 -98 03:18 PM REMAX. GRAND. VALLEY 970 285 1137 P.02
rapt
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_. _. . 0 •1t► ..
October 9, 1997
entity
RE /MAX Grand Valley
P.O. Box 6400
Battlement Mesa, CO 81636 ,
RE: Lots 3 h 4 Layout • Green Subdivision
HCE Project No. 97084.01
Dear Mr. Bentley;
Lou 3 and 4 of Green Subdivision have been laid out according to the plat filed with Garfield
County, dated July 5, 1949. The lots appear to have sufficient area t0 construct both a well and
septic system on each lot while mating required setbacks. The lots arc about half an acre In size
and will have a residence, a domestic water well, septic tank and leach field. The wells must be
at least 100 feet from any leach field and it was assumed that no well or leach field exists on the
adjacent properties.
The possible footprint of the house was assumed to be 2500 square het. It was also assumed to
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have 3 bedrooms and 2 people per bedroom. The septic tank is set back 20 feet from the house,
but it can be as close as 5 feet. The arca available for the leach field was taken as the area left
alter setbacks of 20 feet from the house, 10 feet from the adjacent property, and 100 feet from the
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possible well location. The septic system was sized according to the percolation rate given by
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Rick Bentley of 25 minutes per inch on a nearby lot. The area available for a leach field appears
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to be much greater then the area needed for the field. Sec calculations and drawing.
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4
If you have any questions, please contact me or Tim Beck at High Country Engineering.
4 Sincerely,
HIGH COUNTRY ENGINEERING, INC.
• Eric Tuin, E.1.
Ene.
(
923 Cooper Avenue • Glenwood Springs, CO 81601
a Telephone: (970) 945-8676 • FAX: (970) 945.2555
JAN -23 -98 03:18 PM REMAX.GRAND.VALLEY 970 285 1137 P.03
Project Canoe SutrAivis!ry Job No.
9 708 n/j
wr•. gy fP7 _ Date /0 - ' - ' ' Ck'd by Date
Subject -� , Page t of , L
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1 923 Cooper Avenue • Glenwood Springs, CO 81601
MRR -16 -98 01752 PM REMRX. GRAND. VALLEY 970 285 1137 P. 01
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Form No. OFFICE THE STATE ENGINEER t v, ` � � N R I Gf PY 1/4 GwS z 2 7 , COLORADO DIVISION DIVISION OF WATER RESOURCES i 1. l1 l t,.
816 Cumunnlel aide., 1313 Sherman St., Deriver, Coluredo 80203
' (303) 666 3681
1095
WELL PERMIT NUMBER 2 4 d 2 . 5 .
AP[?TICANT DIV. 5 CNTY. 23 WD 45 DES. BASIN MD
•
emote Subdiv: GREEN
Post - Fax Note 7671 Dere APPROVED WELL ISLCATION
lea GRAF COUNTY
SW 1/4 NE 1/4 Section 7
Twp 1 S Reg 95 W 6th P.M.
UISTANCCS FROM SECTION LINTS
2150 Ft. truer NORTH Section Line
(303)457-0558 1550 Ft. from EAST Section Line
PERMIT TO CONSTRUCT A WELL
ISSUANCE Or THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shell be used in such a way as to cause no material injury to existing water rights. The issuenr..0 Of
the permit riots not assure the applicant that no injury will occur to another vested water right or preclude
mother owner of a vested water right from seeking relief in a civil cow( action.
21 The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 4022,
Unless approval of a variance has been pronto(' by 1110 State Board of Examiners Of Wotor Well Construction
and Pump Installation Contractor:, in accordance with Rule 18.
3) Approved pursuant to CRS 37- '32.602(3((b)(III(A) es the only well on a residential site of ,02 acres described
as lot 4, block 1, Green Subdivision, Garfield County,
4) The use of ground water from this well is limited to ordinary household purposes Inside a single family dwelling.
The ground water shall not be used for irrigation or other purposes.
5) The maximum pumping rate shell not exceed 15 GPM.
6) The return flow from the use of Din well must be through on individual waste water disposal system of the
non evaporative type whore the water is returned to the same stream system in which the well Is located.
71 This well shall be constructed not more than 200 Poet from the location specified on this permit.
e) This permit hos been approved for lot 4, biOCk 1. of the Green Subdivision not lot 6, block 1 as identified on
the permit application. You are hereby notified that you have the right to appeal the issuance of this permit,
by filing o written request with this office within sixty (60) days of the date of Issuance, pursuant to the State
Administrative Procedures Act. (See Section 74.4 -104 through 106, C.R.S.).
NOTE; Parcel Identification Number (PIN): 23- 2407 - 071 -03 006
Assessor Tax Schedule Number: fr270066
PIN & Tex Schedule Number's identify lots 3 & 4, block 1 rd the Green Subdivision.
this well will service lot 4. Lot 3 has a water top available from the Town of Parachute,
The Town of Parachute will not provide lot 4 with a water tap, t l
Thus water service fork)! 4 will be from this well.
APPROVED
DMW .n/ i C
Sete [npinay [� b C 1A Or
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Receipt No. DATE ISSUED Er 0 5 1997 EXPIRATION DATA FP 0 5 1999 .
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