HomeMy WebLinkAboutApplication- Permit‘Pidt, .6Th
' GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
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IN « IDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit
4045
Assessor's Parcel No.
This does not constitute
a building or use permit.
Aok
Owner's NameLCln 1 Si c` 1 e)kC1Pressent Address f -D Il Lt or \S ---R s Q Phone_ (o` J — 1CLC
Get nw 0312 LI'Oons Kidye /J
a3g(-30q-61- .96y<+'bA15 &rd"e ESf4ft Col -
System Location
Legal Description of Assessor's Parcel No
SYSTEM DESIGN
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback Requirements:
Date 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 (� f� /� QA��
Date / ✓Z�-�� Inspector / Cm- /mil titer L�"e ,r
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE o
*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 ($500.00 fine — 6
months in jail or both).
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER - J //// l°. /--- "M73'L"4"
ADDRESS / r / yi - `dPHONE 9d':� n €
CONTRACTOR cQ
ADDRESS
PERMIT REQUEST FOR ( ) NEW INSTALLATION
PHONE
( ) ALTERATION OCS 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 ( 4,r4/» eI 3,..0 —
Legal Description or Address 4g/ i �/z/273',6'14
WASTES TYPE: N DWELLING
Size of Lot !- ,4j- �-
Es -..s s 03 f C Cans fl.4
( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER -DESCRIBE
BUILDING OR SERVICE TYPE: clio q,.4
Number of Bedrooms Nu of Persons
90 Garbage Grinder (X) Automatic Washer
SOURCE AND TYPE OF WATER SUPPLY: (A WELL
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: �jcGe / $ �%.>
Was an effort made to connect to the Community System? �p v75
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 Y
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System (septic tank & disposal field) to Property Lines: 10 feet J
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope,'— /O ,O
en
Q4 Dishwasher
( ) SPRING
( ) STREAM OR CREEK
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:
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? /0
PERCOLATION TEST RESULTS: (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 per inch in hole No.
Name, address and telephone of RPE who made soil absorption tests:
Name, address and telephone of RPE responsible for design of the syss em: )t tn2aeo% �F..t
970 *3- -J ?for 437ir24. ,;>71eArr a i -h73 /1 f' (o x'/623
,- 0i-ec. E -
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.
Signe
PL
Date // -2,2
W AN ACCURATE MAP TO YOUR PROPERTY!!
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September 23, 2005 PINNACLE DESIGN
CONSULTIN ROUP, INC.
RE vEjiTy05 BUCK AD
JCARBONDALE'CO CNT OLORADO 61623
Mr. Tim Holiday SEP 2 3 2005
Garfield County Building Departratait ILG COUNTY
108 8th Street Suite 201 BUILDING & PLANNING
Glenwood Springs CO 81601
RE: LAATSCH RESIDENCE SPETIC SYSTEM
LOT 8, LIONS RIDGE SUBDIVISON
0318 LIONS RIDGE ROAD
GARFIELD COUNTY, COLORADO
Dear Tim:
Enclosed please find two (2) stamped "as built" plans of the Laatsch Residence Septic
System, located at 0318 Lions Ridge Road, on Lot 8 of the Lions Ridge Subdivision in
Garfield County, Colorado.
During the system installation and prior to backfilling the drain field, septic tank, and
associated piping, I had the opportunity to inspect the system. The installed septic
system, to the best of my knowledge, was installed in accordance the original approved
plan and in accordance with Garfield County Standards and Specifications.
Please feel free to give me a call if you have any questions.
R
BR;.
5 C
35088
P i E DESIGN
CONSULTING GROUP, INC.
HEB/heb
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LIONS RIDGE ROAD _------
GLS WATER LINE _ _
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oceda: I. .. 20'-0'
ritr-W
0 40
ENGINEERING BY; PINNACIE DESIGN
970 fed—Z170
0106 Rook Point Road
Cralocedalia Colorado 516/61
ENGINEER
Hans E. /tracker. P.E.
STRUM DECK 111111 INFILISRATOR I&IW DI TREMOR
6' TYPICAL 6' TYPICAL
NEW LEACH FIELD
DRIVEWAY PARKING
SEPTIC TANK
IW
SOLAR DIAGRAM
distance to
irrigation ditch
430' +/—
distance to
Homeowners Association well
1300' +/—
TIMM DESIGN TYPICAL
as nab"
AS BUILT
0
S
TOTAL UNITS = 81
BED DESIGN
9 IDIR TIM + P1XCOUflON Ban ORB 10 IO NOTB6.
10 A@I0110I • 225 BP PER B=ROOM
• 7 BEDROOM Z 2116 -1690
1696 Z .5 = 796 s! / 9X7. 60.66 INPR AA90BS
01 BNPB11/490e3
4e SDR 26
ENGINEERING BY: PINNACLE DESIGN
970 905-X190
0006 Bonk Plat Road
Cnrbmt h. Colorado 01629
ENGINEER
Hens E. Backer, P.E.
STBTN DEIGN NTH DD9LfATOR MAIDItE IN TEM=
D
sale: 1• _ 20 -0•
DISTRIBUTION BOK
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1111111INSPECTION VERN
1
1
1
1
1
1
1
INSPECTION VENTS
10 UNITS PER ROTI+1 = 41 QUICK 4
4' SDR 26
1
1
1
1
1
1
1
1
INSPECTION VENTS
1
1
1
1
1
1
1
1
PORT AIR VENT
O 40
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1
1
1
1
1
1
1
1
0
\ YA INSPECTION TTS
i 411 I
1 1 1 1 1
is
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INSPECTION yin INSPECTION VENTS
10 UNITS PER ROW = 40 QUICK 4
1
1
1
1
1
4• SDR 26
PORT AIR VENT
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LION'S RIDGE ESTATES HOMEOWNER'S ASSOCIATION
GARFIELD COUNTY, CARBONDALE COLORADO
LANS DOPASION
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