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Home My WebLink About02672GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2672 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Owner's Name Bob & Suzie Wheeler Present Address c/o Bell Country Homes Phone_ 984 -3500 System Location / G/ 6 /County Road 331. Silt Legal Description of Assessor's Parcel No. 4, r--4 it 7S3oP6 SYSTEM DESIGN M22 Septic Tank Capacity (gallon) 4'/Other 1 parcb ate (minutes /inch) Number of Bedrooms (or other) 3 4 - don,t S3 40 l2° flied &d Requequ ired Absorpt Area - See Attached Ole d ` / eiN /rs /N,r /l 74 Est B/O P/A-,tias'e4 Special Setback Requirements: yea, Date f 76 Inspector Ve( FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer F ) nr y Septic Tank Capacity /000 Cawe Septic Tank Manufacturer or Trade Name 1/414.? Septic Tank Access within 8" of surface I/ 5 Absorption Area O; 9 //N /rte SS Absorption Area Type and /or Manufacturer or Trade Name /44`71 7?A/U.P5 Adequate compliance with County and State regulations/requirements,J /tf Other ar 72) opee Q Date 96 Inspector J.- RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE CONDITIONS: 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chap ter 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 materialvariationfromthetermsorspecificationscontainedintheapplicationofpermitcommitsaClassI, Petty Offense ($500.00 tine —6 months in jail or both). White - APPLICANT Yellow- DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Afr OWNER gei C ADDRESS d 11 ., / 1 / fl /PHONE CONTRACTOR 6,-/„.../ /A, O ADDRESS ss1 PHONE PERMIT REQUEST FOR 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 ec-1 Size of Lot 4 2 P' z - Legal Description or Address WASTES TYPE:DWELLING TRANSIENT USE COMMERCIAL OR INDUSTRIAL NON - DOMESTIC WASTES OTHER - DESCRIBE BUILDING OR SERVICE TYPE: $.Ld 60,-) Number of Bedrooms Number of Persons c7 lid' Garbage Grinder Automatic Washer Dishwasher SOURCE AND TYPE OF WATER SIMPLY Y WELL SPRING STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Aoy Was an effort made to connect to the Community System? A site flan is required to be submitted that indicates the following MINIMIJM 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 Y1 I DI 1 A E II PI AL T_MPE'WIL IT cE1 i_D WITHOUT A SITE PLAN. GROI IND CONDITIONS: i Depth to first Ground Water Table 0 Percent Ground Slope 77 ff 2 A TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: p<i 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: A 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? Aid pF.RCOI TEST RESI Ti,TS: (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 ofRPE 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 application and in legal action for perjury as provided by law. Signed Date e#0 PLEASE DRAW AN ACCURATE MAY TO YOUR PROPERTY!! k6zta 3 ti z t rit g0 E/ S L v0 7t ag 71 Cl" O aO 5/s J3) a, Ay 1i, ' ,tete4 20 zi /60 1 /S O' o.Q // /fir X CCC oc / t 49vo a0 7 r 7-5-30 iPere lree ( ay , VT - , / 7Y 4U S o ,o ,r