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HomeMy WebLinkAboutApplication-PermitkRFIELD C"if ",]'Y DEpurrnion OF VIVIHONMI IJTAI. %OA:.'1'i, 201.E Blalce Avenue Glenwood !.ci,rt.ngs, Colorado 41601 ;:.,ster7 uontrYact or 3.. C::n„ +treitt1 on api.a -,va1 or; are hereby a)..proved. r'©I4c. r"a4,c 5_.'1c',aa .rl minutes* st . :t. r;, ui i :y r>7`j 4 i fJ1i ars a 4'rea bedroom.��na__.rw.ww+w.+w.rw_.n......,+w+wwrr.rw.rw..w..�.w+..rw.. +.sr..�y.•wix......wwwrr.w X tR' . fe of .s s'i. feet rn a1rt rki re- w.w�+F+rsw t u x.c rite rz C s' :�..a ...,.is�i:........',�.La ... 4.41.1.4 4.191.4401.POR•044 Date Inspector 2. Final appzoval of systems !4) system shall. be deemed to be in compliance with the 30wage Disposal Laws until the assemb.ed system is approved prior to cowering any part.W se t tank cleanout with as seal !� Pro =r materials and assembl Ade uate ahsor tio:2 area n Ade ate ,coryCreteFN.- c�ovar tirells onl } Covenants si ned ...... ' * Retain with permit records at construction site. COLORADO DEPARTMENT OF HEALTH Water Pollution Control Division 4210 East llth Avenue Denver, Colorado 80220 APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS Applicant (Owner): Travis S. Anderson Mall Address: Anderson Camps A. INFO:. TION City: Gypsum, Colo. Phone: 524-2805 ING PROJECT SUBMITTED FOR REVIEW: Attach separate sheets or report showing entire area with respect to surround nn areas, topography of area, habitable buildings, location of potable water wells ercolation test holes, soil profiles in test holes. 1. Location of Facility: County Garfield City or Town Gypsum S1/2 W1/2 sw' NES S1 SEC. 15 NWS AND -4 Legal Description ,4R1/4NF.31: SFr._ 22 ALL TN 3--A7 Lot Size: 720.00 A. 2. Type of area and facility - Number of persons served: Subdivision Motel Restaurant Trailer Court Other: Camp 8 to 10 3. Source of domestic water: Public (name): Private: Well Depth Other springepth to first ground water table 30' 4. Is facility within boundaries of City or Sanitation District: no If so name: 5. Distance to nearest sewer system: 24 miles (Gypsum) Have negotiations been attempted with owner to connect: no If rejected, give reason: 6. Rate of absorption in test holes in minutes per inch of drop in water level after holes have been soaked for 24 hours: 7. Name, address and telephone of person who made soil absorption tests: 8. Name, address and telephone of person responsible for design of the system: Bret's Better Homes. Rt. 2 Box 36, Glenwood Springs, rn1or1do 9. Est. bid opening date: Est. Completion Date: Est. Protect Cost: . Date: ,;2,/L7,Q ? I/j �LLTi'L, r /�rr4� 11 Signatur of wner 8. SIGNATURES FOR LOCAL GOVERNMENT OFFICIALS: The undersigned have reviewed the proposal for the location of the above-described septic tank system and RECOMMEND APPROVAL or DISAPPROVAL in the space provided below: DATE APPROVAL DISAPPROVAL /% /-% Comments: Signature for Local Hearth Department Signature for Mayor or City Manager Signature for County Commissioners Signature and Title Note: The applicant must obtain the comments and signature of at least one of the above. C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION: WP -10 (Rev. 5-70-100) GARFII::i.t) COUNTY ?:VVIRONi•iL TAL L1: 1iLi'" Field Test Data Sheet on Percolation Test PROPERTY OWNER -7-kA V 15 4ivD/'sc N Pliorx 514 – 2? ' S- MILING SAILING ADDRESS Hu- --ro p /k'A A) c l-4 FOR (5/47/...5 SWEETWATIfk C AEZ C LEGAL DESCRIPTION OF PROPERTY 7RA i/ IS ,4,Ut) JZ Sa ,v g c 4 -- 8 /L1/ l e5 1•,16-e-Tkre,g, cue EZ - LOCATION OF TEST I SOLES'TTDT� OF 12 L1G�IL`f.C_. Three (3) test holes recuired per system /2- FEET Test Hole Depths (24" minimum) ---- Diameter of Test Holes Water Remaining after 24 Hour Soak TEST HOLE #1 TEST HOLE #2 TEST HOLE UU3 Drop Time I \ Drop Time / ! \ Drap Tine 3"• ii) fSFU) _ -_ _- l 7 _- — _. Percolation Rate Each I3ole Average Rate / 1 !) S MIA.) NAME OF RES SIG:1ATURE MO 4 4, ? 'ED PRODUCTS, INC. PcBox 248 TEST GLENWOOD SPRINGS, COLO. 81601 PHONE r'f;t S`" G 3¢ DATE SJ±iJ7 3 Gxa.At- s%'1 Se wed lam, �v rt.sao CaarrettL . • II) orrut 6? 4. # 1.d N 2 Bed 1r.a,,,s A X34 #41 S /000ieL re F of ipso A Of" • • ••• • • • i 1 0 1 • CQ very TI G sys+'dM T o) Sewage 't'›-C4,4•oy't Ca. Pi r-Pi'nf 13 - el I ,bobSoa FA/ NcF7-ll ProDu.cfg .SNL R. &o r PO' C4 v o4 " SP>-i/►r.$ col ,(d..at, /We 4YSfe4e. 13k( C' n pti Ae y/ e 0 Iv 0_0` r. cofi' t6 i e .'N a, 4-4 Ad My -- &,-at'g %3 e /'1 e v- HaNt'c s fgWte. � /3t'y N44,g. /0* -5 CrGL.a