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Home My WebLink AboutApplication- Permit.an...,ta er—tp. antra wwW.,: {re;, Zra7F-, , 7n- • -.47.-- GARFIELD COUNTY UILDING AND SANITATION DEPARTMENT Permit 28 ( 1 Assessor's Par&I No. t , 109 8th Street Suite 303 ..0GIenwood Springs, Colorado 81601 Phonb (303) 945-6212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY ti Owner's Name Patricia Murphy System Location J 1 i This does not constitute a building or use permit. Present Address 100 R.P. Ave., C'dale Phone 963-0331 r CR ''a01, Parachute r, Legal Description of Assessor's Parcel No t2 o`c6-- G c nccl - 6 7 L C- T r -+ C y3 C- -t, 1+ . t +r T2C+�+ Septic Tank Capacity (gallon) / Other ti SYSTEM DESIGN f2 SO 1, �r�fCr i Percolation Rate (minutes/inch) Required Absorption Area - See Attached Special Setback Requirements: Date 9 -29-o') Inspector 001b -, . 1 2 i C R T fQrS 725 ft -.s Number of Bedrooms (or other) f ,e?i, A n / CS FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer CU NE t . Septic Tank Capacity /47–re) c. 5 Septic Tank Manufacturer or Trade Name `Q fL ori Not Septic Tank Access within 8" of surface yrs; Absorption Area r . /. / •" AIM Absorption Area Type and/or Manufacturer or Trade Name ZoiDO Adequate compliance with County and State regulations/requirements e -S Other Date 1 e7 • •3 - 7 Inspector RETAIN WITH RECEIPT RECORDS AT CON RUCTION SITE *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. Ainy person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material variatidn from the terms or specifications contained in the application of permit commits a Class I, Petty Offense 4500.00 fine — 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER >'i4 % lc 4g. ADDRESS /40 Rove e L'6- tt ex V '6.3 PHONE q co 3 --- 0:37 f CONTRACTOR P.4 ` - g ! C) 9 44L'grifq ADDRESS pec et -g- 1 N G fD Irk 4 V E j5.23 PHONE cS A-1 E. PERMIT REQUEST FOR (1f 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 Ll 5 0 43 Size. of Lot C Legal Description or Address k®-7- 2 Aray✓-&-, cci J7i V/5761 AI WASTES TYPE: 1 LLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: I?L E- / D f A uYJ4/ Number of Bedrooms Number of Persons ( Garbage Grinder ( utomatic Wackier (L}6ishwasher SOURCE AND TYPE OF WATER SUPPLY: (t4 WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? i1.t) A site plan is required to be lubmitted 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 ISSUED WITHOUT A SITE PLAN. GROUND CONDITIONS: Depth to first Ground Water Table Percent Ground Slope TA9' rr- A E � L 2 TYPE F INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (fri 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 EFkLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? 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 system: 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 m legal action for perjury as provided by law. Signed 47 114 Date 7 " / — 97 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 • Lot Lyons Subdivision Exemption ti0 94 A trod of land situated In the SWI/4NW1/4 of Section 5, Township 7 South, Rang Writ of the 6th P.M.. County of Corflold. State of Colorado. said tract of lend 14In being mar particularly described as follows: titBeginning at a point on the Northerly Right of Way of County Road #301 as constructed and In place from which the West 1/4 comer of sold Section 5 boars I 5.04109'40"E. 15.6a feel, said Wert 1/4 caner being o stand wd monument and brow cap. P.LS. /14060; then along the Northerly Right of Way of maid County Road I N.Ii5.D6'26'E 515.15 f..1; then N.02'27'S0'W. 1270.56 I..t to th. North lin. of I Bald SWI/4NW1/4; then along *aid North Ib. 5.5910'29'W. 553.59 f.•t to th. I Northwest corner of said SW1/4NWl/4; then along Ih* West line of sold SWI/4NW1/4 5.04'09'40'E. 1290.62 feel to the Point of Beginning. I Sold tract of land containing o net acreage of 666,257 square feet or 15.75 flora I as described. N1/16 Corner Sections 5 and 6. #5 Rebar and Mum. Cap, P.LS. 1276I3 To Br 5e1. O op { / / / / / / / / / 1` .. it l West 1/4 Comer Sec. 5. Found Bross Cap, P.LS. 114060 100 0 50 100 200 N8910•29% 1.59` r Centerline of 10' Wider Irrigation Ea.em.nl as Reserved In Document Recorded In Book 03 at Pogo 350. UOT g 41 i) scr4LE- yo wJs vu nir Al Ksga 4 Q1. O• ugPa y N04'09'40"W 15.68' 'i Ffas>£ la DRAM FL, It_le — prt'IC #140 18e 06'26' 815:13' P.we 0.0144