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Home My WebLink About0452301-75 opi(cf5 SUS. INDIVIDUAL SEWAGE DISPOSAL PERMIT GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 401 4 5 2 3 Glenwood Springs, Colorado 81601 Permit Phone (970) 9458212 ".._smoieMNb,7_ � n This does not constitute a building or use permit. PROPERTY i Owner's Name 'JCRT Present Address D�193\E� �� , Phone 4 , "`[595 System Location DM,I (r704- ) `/i \NS Legal Description of Assessors Parcel No. — D bO (p ) 6-11-- SYSTEM +SYSTEM DESIGN % Septic Tank Capacity (gallon) Other /6; 4' Percolation Rate (minutes/inch) Number of Bedrooms (or other) "7— 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 0A/ex - Septic Tank Capacity Z Sa Septic Tank Manufacturer or Trade Name C0,042/4"4-4/110 C Div i re Septic Tank Access within 8" of surface Absorption Area // 6, Absorption Area Type and/or Manufacturer or Trade Name // G/r// ep 4 %vr--/# Adequate compliance with County and State regulations/requirements Other Date /9 4' '— a c� Inspector 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 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. Connection 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 1, Petty Offense ($500.00 fine - 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT GARF'IELD COUNTY SEPTIC PERMIT APPLICATION 108 8th Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003 ww . • arfield-co nt .com 1 Perk Fee: Parcel No: (this information is available at the assessors office 970-945-9134) -69 304-00(Q. 2 Building Job Addrean� d is F�ICnassigned, please provide Cr, Hwy or Street Name & City) or and legal description Me act L '.Loi - . X11 buoy-uA k ;fi S 06 3 Septic Permit #:57.5 Lot ize: Lot No: Block No: Subd.l Exemption: A k 4 Owner: (property owner) ) - �[ Com S t [. c_ Mailing Mailing Address /`�y cc k p4i,e- l.f f Ph: /� - "��C J Alt Ph: } f t� � (. (2 1 5 Contractor: -Tr love exc tuxriv Mailing Address Ph: Alt Ph: 6 Engineer: W ► 1 { 3 44,vi 0,...,1 Mailing Addre s O oS P(pt rye C4- Ph: 456,Alt � 4615 Ph: 30-;, 1.6 b31 7 PERMIT REQUEST FOR: ( New installation ( ) Alteration ( ) Repair 8 WASTE TYPE: }welling ( )Transient Use ( )Commercial or industrial ( )Non- Domestic wastes ( )Other -Describe 9 BUILDING OR SERVICE TYPE: Number of bedrooms 2- Garbage Grinder (y)Yes ( )No 10 SOURCE & TYPE OF WATER SUPPLY: ( )WELL ( )SPRING ( )STREAM OR CREEK ( )CISTERN If supplied by COMMUNITY WATER, give name of supplier: QDi i2-4' °zvo A.j- oiweaw. 1.-�2's .11-c$0c:4)1-777, a 11 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? i i7—OC' A6 YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN 12 GROUND CONDITIONS: -} Depth to 1st Ground Water Table Percent Ground Slope /' c.' 13 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (1SDS) PROPOSED: ()Septic Tank ( )Aeration Plant ( )Vault ( )Vault Privy ( )Composting Toilet ( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy ( )Incineration Toilet ( )Chemical Toilet ( )Other- Describe 14 FINAL DISPOSAL BY: )Absorption trench, Bed or Pit ( )Underground ( )Wastewater pond ( )Other- Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter Describe fs 15 Will effluent be discharged directly into waters of the state? ( )YES ( NO 16 PERCOLATION Name, address Name, address TEST RESULT: (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 No. Minutes per inch in hole No.2 Minutes per inch in hole & telephone of RPE who made & telephone of RPE responsible soil absorption test: for design of the system: 17 Applicant acknowledges the local health issuance of reports submitted and are designed understand and lege � OWNS' that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by 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 the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and h, ,e ' h and requir-d to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief • I, •lied on ay)' e local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further th. . .:i air) or/ isrepresentation may result in the denial of the application or revocation of any permit granted based upon said application �� j rya'. �•�'ided r i� � 'irn GNATURE D1(01 TE STAFF USE ONLY Permit Fee: �0 Perk Fee: Total fees: Building Permit #: 11. Le (10 -�. Septic Permit #:57.5 issue Date: i Oil Bu' 9 ug & PI. li i►tg A' °..r.- Illi APPR E V . DATE William J. Young 205 Alpine Ct Glenwood Springs, Colorado 81601 August 5, 2009 BYCADS 0152 Home Place Glenwood Springs, Co 81601 RE: ISDS Permit — Completed Installation -- Final Approval Letter To Whom It May Concern: I have completed the final inspection of the above referenced project for the tank, distribution box, and infiltrators for the ISM installation. The completed work for this phase of the project includes: 115 Infiltrator Systems Quick 4 chambers and 10 end caps. 10 Monitor ports; one at each end cap. Two distribution boxes and associated piping to each Quick 4 end cap. One 1250 gallon two chamber concrete septic tank. Sewer line from septic tank to westernly distribution box; with cleanout for each direction. Sewer line from house to septic tank. Sewer line from detached garage with wye into line from house to septic tank. All work has been completed to within the specifications as per the drawing stamped and dated October 6, 2008. If you have any questions or comments, please call me at 970-987-2139.