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HomeMy WebLinkAboutApplication-Permit.pdfGarfield County Building & Planning Department 108 8th Street Suite 401 Glenwood Springs, CO 81601-Phone: {970)945-8212 Fax: (970)384-3470 Project Address Parcel No. Subdivision DEBEQUE, CO 216921400026 Owner Information Address OXY USA WTP LP 760 Horizon DR Grand Junction CO 81506 Permit NO. SEPT: ~ 7-10 .. 1631 Issue Date: 12/1/2010 Phone Pi3rrnit'.Tn/e:'.!i>epticperl11it Work,Glassification: New Peimil8tatus:Active Expires: 12/01/2011 Section Township Range Cell Contractor(s ) Phone Primary Contractor Required Inspections: Proposed Construction I Details Vault and haul associated with drill rig minor temporary employee housing at well pad 697-16-16 FEES DUE FEES PAID Valuation: $ 0.00 Total Sq Feet: o Fee Amount InvTolal Paytype Amt Paid Amt Due Septic Fee ~ New Total: Wednesday, December 1, 2010 $73,00 $73.00 Inv # SEPT-7-10-2034B $ 73.00 Credit Card $73.00 $ 0.00 Fo, '",p"t;o", coli, 1 (888)868-5306 Inspection IVR See Permit Record Building Department Copy 2 I I 2 3 4 5 6 7 8 9 to II 12 13 14 15 16 17 GARFIELD COUNTY SEPTIC PERMIT APPLICATION 108 8'h Street, Suite 401 , Glenwood Springs, Co 8 I 60 I Phone: 970-945-82 12 1 Fax: 970-384-3470 1 Inspection Line: 970-384-5003 \\ \\ w.Qar l-lC Id -COUlllv.f.:OIll Parcel No: (this information is a\lailable at the assessors office 970-945-9134) 216921400026 Job Address: (if an address has not been assigned, please pro\lide Cr, Hwy or Street Name & City) or and legal description App. 22 miles NW of Town of Parachute' NE 1 /4 Sec 16 T6S R97W 6th well P . M. Lot Size: Lot No: Block No: Subd.l Exemption: 10,303 Acres N/A N/A N/A Owner: (pwpertyowner) Mailing Address 760 Hor1'l.on Dr Ste. 101 Ph: OXY USA WTP LP Gran" Junction, Co. 81!'t06 970-263-3637 pad 697-16-16 AItPh: Contractor: Mailing Address 760 Horlzon Drive Ste. 101 OXY USA WTP LP Grand Junction. CO 81506 Ph: 970 -263 -363 7 Alt P~70 -412-277 6 Engineer: N/A Mailing Address Ph: AltPh: PERMIT REQUEST FOR: (X) New Installation ( I Alteration ( I Repair WASTE TYPE: ( IDwelling ( )Transient Use (X)Commercial or industrial ( )Non-Domestic wastes ( lather Describe BUILDING OR SERVICE TYPE: Se~age: ~iillIJ t.5 a:';i:';iQci ated ~i tb dt:~ J J t:ig tem~ot:a~ emclQ~ee hous i ng -Pad 697-16-16 Number of bedrooms N/A Garbage Grinder ( IYes (xINo SOURCE & TYPE OF WATER SUPPLY: ( IWELL ( IS PRING ( ISTREAM OR CREEK (XICISTERN If supplied by COMMUNITY WATER, give name of supplier: rlater: ball] eo tc JccatjcD b~ Down ~al]ey Se~tjc DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Town of Parachute app 22 miles t o the Southeast Was an effon made to connect to the Community System? No -distan~~ tQo gregt YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN GROUND CONDITIONS: Depth to 1st Ground Water Table app SO feet Percent Ground Slope < 10% TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDSI PROPOSED: ( ISeplic Tank ( IAeration Planl (XiVault ( IVau11 Privy ( IComposting Toilet ( IRecycling, Potable Use i )Olher-Describe ( IRecycling, olher use ( IPil Privy ( )Incineration Toilet ( )Chemical Toilet FINAL DISPOSAL BY: ( )Absorption trench, Bed or Pit ( IUnderground Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( ISand filter ( IWastewaler pond (X)Other-Describe TQ\'ill Qf ~e~ Cgs~le wa~t~ ~te, I[eatment Eg ~ilit ~ Will effluent be di scharged directly into waters of the state? ( IYES (XiNO PERCOLATION TEST RESULT: (to be completed by Registered Professional Engineer, if the Engineer does Ihe Percolation Test) Minutes NlA per inch in hole No, 1 Minutes N/A per inch in hole No.3 Minutes "'IA per inch in hole No.2 Minutes Nl8 per inch in hole No._ Name, address & telephone of RPE who made soil absorption test: N I A Name, address & telephone of RPE responsible for design of the system: ~l A Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be requ ired by the local health department to be made and furnished by the applicanl or by the local health department for purposed of the evaluation of the applicalion; 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 misrep;lffnlatiOn may result in the denial of the applicalion or revocalion of any permit granted based upon said application andlegalactjon~sJ~lj w. r}~/;j ~, 9', 6 /~ OWNERS SIGNATURE ~ DATE 1 f ?D 7~ .OO 1 \'0110 c.c... STAFF USE ONLY Permit l ~ 00' rerkFN\ A Total fees: Building Permit #: ,3, 00 -\1.030 Septic Permit #: 3EPT-i-IO -Ito51 Issue Da\~ -0 1-00 l( ) BuUding & Planning Dept: ~~ APO~-/~~./DATE 3-4'DIA HOLES NOTE' , -SEE XERXES' ONE YEAR LIMITED WARRANTY , -fOR UNDERGROUND SEPTIC TANKS INVERT DIMENSION fROM TANK I.D. ~ \ -"" J J ' -lIB L '1''' '1''"' ~ f" '" "0' ==r""l FULL BAFfLE DETAIL ·C· , 1 J/4' SCALE: 1/24 ll~ h ~~ '" I 'I 110 ! ' I '" , i""' i~ I, I, I ' II, I ' I " I ' II" II H II" I" I" /I'" "d .. --'""-"" 1& 3/4(TYP) f--,,-6 1/2' o ~''''' .. """,", .. .,. ... -® 5'01A SCH 40 PVC INLET PIPE WITH INTERNAL SANITARY nE '" PIPeS ® RISER PIPE, ,OR 24"(NOM1NAl) ACCESS OPENING XEIq(ES· © fUll PLATE BAFFLE (46" INVERT) WITH J 4'DIA HOLES ,. :"'-1 S'IIIA SWT ~,'k ":"' CAP, ID,OOO CALlOilS WoRAIHON Oil W'ST~ ® LIFTING LUG <xl HOlD DOWN STRAP LOCATION '" _... 0 632-638 00 _',"".,'-0' ~"~' .. .. , ~,