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HomeMy WebLinkAbout04210Nit)t-uia s -H-6(.0 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name -xofC e� Vr useS Present Address k System Location GO-Dbb LI (151 -A -Th looLt Permit 4 2 1 0 Assessor's Parcel No. Legal Description of Assessor's Parcel No SYSTEM DESIGN This does not constitute a building or use permit. , -y Phone Q 1 4 cR— [ -f ,(0aL0 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 Date /0 *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). u6. Inspector 1 i r' RETAIN WITH RECEIPT RECORDS AT CON(TRUCTIOM SITE Whsle - APPLICANT Yellow - DEPARTMENT GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name VV r di LA\ Present Address System Location lDL i Legal Description of Assessor's Parcel No r�yr� t11 - 1— 0C SYSTEM DESIGN f f, Permit Assessor's Parcel No. This does not constitute a building or use permit. Phone H 7 — ( _ ,(.0Q(4) 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 Date Inspector f �'-� t •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 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). White - APPLICANT Yellow - DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER eitC e ADDRESS 7zes,V 11,0407 CONTRACTOR ('cj n ei2 ADDRESS S /fiyt e / v < PHONE CNS' Z 2l, PHONE PERMIT REQUEST FOR OQ 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: (st) Near what City of Town 6:40 ra o 1 Set Size of Lo Legal Description or Address , CI L° ,% � �C,L1/1, gaaNtirk WASTES TYPE: ( ) DWELLING ( ) TRANSIENT USE (COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER --DESCRIBE BUILDING OR SERVICE TYPE: rr• Qjvi. 1 l_ DI v -r Number of Bedrooms ( ) Garbage Grinder ( ) Automatic Washer SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL If supplied bCommunity Water ive name of supplier: Number of Persons 1 ( ) Dishwasher ( ) SPRING DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: ( ) STREAM OR CREEK U lA Was an effort made to connect to the Community System? 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 Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System (septic tank & disposal field) 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 2 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (y) 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 ( ) UNDERGROUND DISPERSAL ( ) ABOVE GROUND DISPERSAL ( ) OTHER -DESCRIBE ( ) EVAPOTRANSPIRATION ( ) SAND FILTER ( ) WASTEWATER POND WILL EFFLUENT 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 depai Lnient 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 perinit 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. XSigned Date PLEArS WAW AN ACCURATE MAP T OUR PROPERTY!! 3 Designate North Arrow Your Neighbor's Name & Address Your Plot - Shape to Fit (No Scale) 0 eX (36 \3 {Lpt Locate well, all streams, irrigation ditchs, and any water cours s. raw in your house, septic tank & system, detached garages, and dive ay. If a change of location is necessary, you must submit a corr:'cted drawing, before a Certificate of Occupation will be issue Your Neighbor's Name & Address County Road (Note the Road Number and Name) eric cAwpwinfiOlwpdocslplot.loc A) ppo- JUL-17-2007 12:59P FROM:ROARING FORK RENTALS 19706253614 TO:9459435 P.1 6SCHMUESER ', GORDON i MEYER ENGINEERS SURVEYORS October 17, 2006 Garfield County Building and Planning Andy Schwaller — Chief Building Official 108 8th Street, Suite 201 Glenwood Springs, Colorado 81601 GLENW00D SPRINGS ASPEN CRESTua Bur'1E I 16 W. 6Th. SUITE 200 P.O. BOX 2 F 55 P,0, BOR 3099 GLENWOOD SPRINGS, CO 81601 ASPEN, CO 818 1 2 CPE1ITED BUTTE, ca a t 254 970.945- 1 004 670-925-8727 970-349.5355 FX 970945.5948 FxI 970.025-4157 FK! 870-349.5358 RE: CHOICE VENTURES (ROARING FORK RENTALS ISDS) Dear Mr. Schwaller: SGM visited the site on 10/16/06 to evaluate the completion and construction of the septic system for Roaring Fork Rentals property. The septic system appeared to be complete and in reasonable conformity to the approved plans. If you have any questions please contact me directly at (970) 945-1004. Sincerely, Schmueser Gordon Meyer, Inc. Brandyn J. Bair, E.I. Design Engineer CC: Jeff Orosz Roaring Fork Rentals PO Box 1670 Rifle, Colorado 81650 12006-4651RF Rentals ISDS acceptance tatter UL -1? -2007 07:25A FROM:ROARING FORK RENTALS 1970E253614 T0:9459435 P.1 Roaring Fork Rentals, Inc. 7264 Hwy 82 Glenwood Springs, Co 81620 970-945-2626 July 17, 2007 To Whom It May Concern: Due to excessively busy schedules, we will be unable to have our parking lot asphalted until the end of August. We have contracted Asphalt Services to complete the job. Sincerely, Jeffery Orosz President Roaring Fork Rentals, Inc.