The URL can be used to link to this page

Home My WebLink AboutApplication- Permit�-r1a-o5 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT Permit 4053 is Parcel No. This does not constitute a building or use permit. PROPERTY t �,[�p�l� 1 r`�i�(Dadsl ( � Owner's Name t�P)en k, �r�(Secresent Aydddress EC ,�i� �l ` `� \il" ` PhoneC 4 /3 System Location QST �$ l F-�(Jk j CO 'F' f719r I "7P 1 c lQ1 Legal Description of Assessor's Parcel No (9 7 7 -in- 00 - L/ /,5' SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or oth Required Absorption Area - See Attached Special Setback Requirements: Date r) L? Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other A-51 11 / I �f% Date 1C7.510 to Inspector tBL neer- C�tris-fOPker n9cw ' 1, RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE jr-50.5-7g *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 (5500.00 fine — 6 months in jail or both). Unita A 00 Ir A UT Al 11 n•MT% mut INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER L ,/2 ADDRESS rr Iwy&za i{ PHONE 74 o- r fC�G CONTRACTOR - !Pei c -/'M r ADDREssxy(rr / 02-(94( PHONE -07 oro1ivc PERMIT REQUEST FOR (`'j 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). LOCATION OF PROPOSED FACILITY: Near what City of Town 474 Size ootr� d -&-/c Legal Description or Address* j.' Car /9Gv/ (6) WASTES TYPE: ( ) DWELLING ( )ITRANSIENT USE COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER -DESCRIBE BUILDING OR SERVICE TYPE: (3151-4"' Number of Bedrooms Number of Persons ( ) Garbage Grinder ( ) Automatic Washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (C) WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: a_,4 "2, Was an effort made to connect to the Community System? /dame.e.21, MU A site plan is required to be submitted that indicates the following M distances: Leach Field to Well: Septic Tank to Well: Leach Field to Irrigation Ditches, Stream or Water Course: Septic System (septic tank & disposal field) to Property Lines: 100 feet 50 feet 50 feet 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN. GROUND CONDITIONS: Depth to first Ground Water Table 6 /,. Percent Ground Slope 2 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( 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: ( v) 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? /t/O PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes 4 t / per inch in hole No. 1 Minutes /2 tS per inch in hole No. 3 Minutes /7 h per inch in hole No. 2 Minutes per inch in hole No. Name, address and telephone of RPE who made soil absorption tests: Name, address and to hpnepf RPS pponsible for design of the system: � C ;vL-A_Lat-,o 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. Date CURATE MAP TO YOUR PROPERTY!! 3 0 N oaz 3 os A 3 a) "Ful o c 0 U ttl OU 3 qN I = • .D o e cccct I ti 0 N • L O • sy ;o • U • U .t Os U 6.1 • U O ti ti 0 N bo 3 , � O 0 ( Dt o 4r o '—' County Road (Note the Road Number and Name) x 1 lesime COLORADO P.O. Box 1301 RIVER Rifle, CO 21650 Nispsilme5-49 33 ENGINEERING, INC. Tel 970 -625- 56 Fax 970-625-4564 January 25, 2006 Mr. Bob Regulski Big R Commercial Park POB 9 Rifle, CO 81650 RE: Big R Commercial Park Subdivision — ISDS Lot 2 Dear Mr. Regulski: As requested, Colorado River Engineering, Inc. (CRE) has completed a field investigation to examine the construction of the Individual Sewage Disposal Systems (ISDS) for the building on Lot 2. The construction has been completed as necessary for the existing building in accordance with our plans dated 8-16-05. Expansion of the system will be required if you construct new buildings in accordance with our plans. This letter shall serve as certification that the system is constructed in accordance with county and state regulations. Christoph i era, P.E. Cm:cm ISDS Lot 2lnspectdoc • 2177 111-O2-357 Scott ono/ Lindo Br yndildson 1831 Po/It-cool Ave Rale, C❑ 81650 Proposed Septic and Leach Field 40' x 40' 1' 0 0 Vi 15' Utility, Easement Exist. Fence(' 10.00' 10' Nan -exclusive Public Service easement. Book 943, Pape 189 357 Linda od Ave.