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HomeMy WebLinkAbout0410801 -31 -Dc -d eflt-a;vd GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY 1'�\ 1 Owner's Name ` IQ _ /��t ��� � Pressen Ad System Location 0Z 3n mon Legal Description of Assessor's Parcel No. ass ` l \ 1.1 I' '' S -Q- 02/ 77- ,=.a -DD - /CoGI Permit 410 8 A r'a Parcel No. This does not constitute a budding or use permit. uaS- 101 (D 3-3 - 135S Phone S1 co- Ssa* 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 �lI S'��' ��'([��,','`�''p,��� !'� 6J - be 1 JO Cs Inspector BqV DQsu 4 i -3tnt � 6 J -be r RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE p' L' 5/110 *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 off ice 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 (8500.001ine — 8 months in jail or both). While - APPLICANT Yellow - DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER uAuid And Di RN �IAZ ADDRESS 41► f[ 11'1' St S iF QD J - PHONE $7(0 • SSa4 CONTRACTOR ..TE)( bid Rem — Reu cz Cor..51,-,,,s{ 0.2 ADDRESS 3S4 f5 1-} LA.. lab aU S L�Ca PHONE 811,- 15X3 PERMIT REQUEST FOR (i4 --EW 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 R,clz Size of Lot -IN 4cr`s Legal Description or Address Tb S R q y W Sem - 0 . ;t5 : st ply N c i1 WASTES TYPE: ( DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER—DESCRIBE BUILDING OR SERVICE TYPE: EA iiL clwe.l)„i Number of Bedrooms Number of Persons off. ( ) Garbage Grinder (�utomatic Washer ('shwasher SOURCE AND TYPE OF WATER SUPPLY: (k)-(4rELL ( ) SPRING If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 2 mi)e5 ( ) STREAM OR CREEK Was an effort made to connect to the Community System? ND — NOT /304 I iih 1 e A site plan is required to be submitted that indicates the following MINIMUM distancesi 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: ( yr7SEPTIC 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: ( v) 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? 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: ]1yr; c L )al#.r 113 t(,W St- 5,a, CO 116 - SRzg Name, address and telephone of RPE responsible for design of the system: nen, U,L 1ler 1al3 1tt' 51- S;Ik,an Mk,- 522.y 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. Signed Date t j o/o S PLEASE DRAW AN ACCURATE MAP TO PROPERTY!! 3 1 n 0 0 r- } F .. o ' W ti co 0 o —N O• a. O f n0,4 fD 1:0 M o n. s 0Oy �_ C o 0- O a W c w `< = o131 w eD w 0 1• N CA `N' 0 W 0 N a c G. O a 'm O' , O •O SD w D en,a, l 0 z.< no ry pc -g2 o c •.c CD t o P -G R°Z r 96 s' a c r U d N O N y H 6 1 N rnN 9(p FEC t m r molly quoM avuSisa( M RESULTS ADDRESS DEPTH APPROX. TEST HOLES TIME Idi'N II DESCRIPTION AND DIAMETER GALS ADDED. WERE PRE-SOAKED HOLE REF MARK TOH2H2O /------- 6F ThZ�T OF HOLE HOLE #1 " FALL (J PERCOLATION C �_E #1 =L0" #1 5 FROM MPI RATE 7 - I 0 (D0141_605 TIME qts U_6,_ke-�_�t�AUSH lZ 0 I 1 HOLE (Time) HOLE REF MARK TO H2O /'� #2 1.48 #2 5 f-::‘'E3C)e'i #2 " FALL �'7 TEST M�ESF __ " © 1 TO MPI RATE % JOB GATE_ Z " 0 HOLE (Date) TIME C (0/5 # --D-1_3-‘2_ �/ ZJIh�w Q #3 L1 U_ { p3 J___ /I74Gf) ( HOLE REF MARK TO H2O ___.---- l2-00`) " 0 Time) 5:30pm #3 FALL k _ 1z- MPI RATE .r 7•� 3,V .i/ / I I �' Dr I %" ,; In 1' 9 ,5<3I , l I . (0,� 3 I1,5 / � I I f I - lip % I .1 ie !II _7,1 ! ID ID It 3 yKS tiles i2..5 1,1 9,1 iy 15 1(2- 11,7 1,5 10 I,t{ i0.7 /0 /" it s % 10%" 1,1 9,1 00.9 I1,- i,I 9,) usE 12 usE-- 3 use- ) 1 AVERAGE PERCOLATION RATE. 11 MPJ g o . PROFILE HOLE AND SOIL DESCRIPTION REMARKS, (,e I pogrophy, omb,ent/sod/voter lempero(ures. msu/a ,tin on sde. weother, vegetobon, site descr,pbon) S0f»ezE Er -Renal/ tay FP -CM Reran- 1 7 Art-- o.g 67.1.a Le ' �t A5+1 1-0( t1 u> 7)RDuaherS. .SCS slurp ZYDSGA-D mcon n7£" 3 w�l" in"lEhvnr-y_ /Nee_ wee, rNu2isa 11 i LT E,kc:.tZM%lsn>K _P 0✓oz - t /&S t'x are l7FSrGd I/NGvE rVgyp R b2 ZD Mit Lye- L off,,, .� • . z;:i6etvo 'ISlr (,r:a r 3711' 1l r 9 �•.. ,, , r.:. ., T 1 I SI •••••• • ' _, By Jo-'icLit,At `‘ /ON Al `�%N` .. Boundaries Unlimited, Inc. SCALE 1 "_ 923 Cooper Avenue, Ste. 102 Glenwood Springs, CO 81601 tele 970 945 5252 fax 970 384 2833 DATE F I LE SHEET n c 9>L2o 2Rm Ter OA >g -l( gR2 :1 i Sinn y3 gRg .St 3Nf1 AIddIS D/0 m -1Z zmu) 0> in= o r C zNa mzmm N O Z f -IO AaC -I rra Z m . • - . ml gr 2gma n g �g g$p D 2 7.z 0= Imn g A4 Am 4 _€ 29 m Baq -12 rVig HD yT $. 2 mm pt 2$o B1 Pt R Bt O 4 n z dN 00 >21 zEl - zz0z zrrao 0 0$11m tm m N • O x • IM Gartlold County. Colorado Diaz Residence Individual Sewage Disposal System Design for Thee (3) Bedrooms i David and Dian Diaz 970.876.5521 Qq�p1q G ties DES. WW N0. DATE . r1llmited nc DR. DAV - dawning & CMI arca. at: PAN 923 Craw. Alma. Sc.. DATE:fi 3/05 Glm�mr Spinp. CO tar 970.9455252 In 9703842 REVISION W z H r 2 0 CO // //< N\\ i• 4" m P1 r P1 m 4' PVC RISER YATH EFFLUENT FILTER 4' I'.h=� *t:WE LI <K 18" 3UVIJS HSNIJ A 0 w d) m m 0 co 0 r 0 artr m 4' 0" sr O c 8' 0" STANDARD INFILTRATOR TRENCH DETAIL s6� - 1 Z• 20 -o 0 g 5 C -n 1- n ✓ z m 0 -n rTi 0 -o r�— L L 1 J R 0 rnZ cn lI`d13U Imo NV310 a "tO -1 A 1 myna C r a 0 2 Oms • p0C m -Pi p=D -13 =1gm 0 '2>a � aN -o Nr1 o 3A Or' t N m Z m 3OV80 HSIN G&Reu County. cowedo Budges White River Resort Individual Sewage Disposal System Miscellaneous Details 1 lack HarrIslon 21679 E. Otero Place Aurora, CO 80016 303.690.6627 ■ Sir Unllmlled, Inc favuenN eCne Engineers One e.wa uSu finma5pnnq ea 111110 eeaeaea r..:emaeu DES.: D1W DR.: DJW GR.: PAH DATE 6/23/o9 DATE REVISION r • Eo 131 0 ak co 0/3 Z r z* U) z°at"1z m O�z-°Thaa =orlm_ >rimo z p0!norr Z�r>ZOZ 0 Z r r > 2 o<nr^ �m mCn rn z co zmo E yOr r z y > �mn mzto a f>0 m > y rr> Z m 2 2 9 0 n K i 0 N c TTg p° gPR 22c$8: oi me nQZ 59: N cn7Z 2pp Fn'nI m 3i€ PRP, 4 > IMn tl31311vlq 11Y1SNI �o 4rI R yQ AZ lnCC2N �Y < onGro F� sa Yti�Fp gi •0 mm y NZ mm yNnA eL OQ gGF ' 2,1 igiq2; m 119Q�2 tNt F1 MAm 11W6 Ng girt Nn Om N�Im9Q0 02 y0s ivi " S m CI 85 og n€ ?t0Pogo zF N iOr �� o D 2'ga 9 o ;rola F Ail" 6AP0 ON N DA Gadleld County. Colorado Diaz Residence Individual Sewage Disposal System Design for Three (3) Bedrooms mCA Z vy =r O 7C -7C —0 io 2I • O r r O z ('d,.1) 121Od NOLL03 David and Dlan Diaz 970.676.5524 9 iiriaarles OM: DAV R0. DATE n lmited nc OR.. DAVCm eS.49 0e9 Enalneen Ca.: PAR 923 Cooper Al9ue. Ste PA GeE OS Gemmed 9pina CO0O ISO tele 970919292 tat 970392 V REVISION • • z V/ m 0 m r z y N z .71 co 4" PVC RISER WITH EFFLUENT FILTER b4' IPVC' itsPR 0 00 N m m 0 to 0 r .'a 0 T r m 8' 0" 18- 1 8" 8' b 18" n O m z 0 O Z co co z ✓ D 0— z F 0 • TI m z n 2 o Isar m €_ 88$ ✓ �ld 3' 0" 11.-0.. L PSS A m Z m r r L r ra L Z 1 r 1IV130 MO NV313 J A N Z rri 30V80 1-ISIN Garfield County. cameo Budges White River Resort Individual Sewage Disposal System Miscellaneous Details 1 Jack Harrlelon 21679 E. Otero Place Aurora, CO 80016 303.690.6627 6 tlarles ors Diw DAti caessaowEaInc ca.: MN caress W CK.: PAM en outer *flume Po- to DATE: 6/33/05 Glenwood epanp, CO 2180 Ike: 9709454]N Mr e70. DATE REVISION BY