HomeMy WebLinkAbout04075C42.12A-01/4
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
Permit
4075
Assessor's Parcel No.
This does not constitute
a building or use permit.
PROPERTY ,,\\\1.-: {� c� 11 _ L f�e�
Owner's NemelJ�"iL • 1`L Present Address &-fl )9 f . iercRI • Phone-—
Y (Sic_
System Location
Legal Description of Assessor's Parcel No
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 ^ %/�1
Date G -- W Inspector Den C' (�•�•/� ( Jay/
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE L1,11
*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 aviolation 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 (5500.00 line -8
months in jail or both).
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER tJ /121-4-- `` 1-0 a-2.- g
ADDRESS O7 /42-4! r_ o s P/ PHONE O 3lJ-6 f'0 6 C Z7
CONTRACTOR 0-110 itA G Sovl6
ADDRESS PHONE
PERMIT REQUEST FOR (s) 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 Size of Lot
L fjoc S 4 o .11-t- f/4 r 7o%S L, `e N�f �9
Legal Description or Address 3oc4
WASTES TYPE: ( ) DWELLING OQ TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: ve4Qer c-,-,1i-PS
Number of Bedrooms % Number of Persons
( ) Garbage Grinder ( ) Automatic Washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING (STREAM OR CREEK
If supplied by Conununity Water, give name of supplier: l
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 4/O N+ • 4e -e -
Was an effort made to connect to the Community System? - 1V 0
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 //f}
Percent Ground Slope 0 —
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: Cdtkiwrigor_eb [L
2
()CI 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:
CA 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 71 3 per inch in hole No. 1 Minutes 1 qr , per inch in hole NO. 3
Minutes 1 / per inch in hole No. 2 Minutes per inch in hole NO.
Name, address and telephone of RPE who made soil absorption tests: %?-o-- 0A-LTerR01/2_444bitcars
jl,iutr✓t.z"r3n.a n/' . 923 CST - ( akvcvo S�, c,s ct= S7/161
qh'- -`)4s -SrSL-
Name, address and telephone of RPE responsible for design of the system: Stole-
Applicant
tole -
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 /7
Date 6 --12,s-,-0,3"
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
WHITE RIVER RESORT INC
21679 E. Otero PI
Aurora, CO 80016
303-690-6627
303-690-6628
Date: 6.S
To: F 1 c%2 ' c --
Fax #: % -20• f - e2 933
R Page(s) to Follow
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RESULTS OF PERCOLATION TEST BUI PROJECT BU2:16. $_
ADDRESS
DEPTH
APPROX.
TEST HOLES
TIME
o.00
DESCRIPTION
AND DIAMETER
GALS. ADDED:
WERE PRE-SOAKED
HOLE
REF MARK
TO H2O
OF
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(Date) lei
TIME
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REF MARK
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MPI
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DATE
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(Date)
TIME
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REF MARK
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GIBES PROFILE HOLE
No iu p� 14 AND
REMARKS (e. topography, ambient/sal/ovate tempo atu es, ^� {%vb/
,p . insNo%tio'n J�s"ite woo er, vegS.etati site desoript' 1�1
/O� l QUQT ...5 KJ/
SOIL DESCRIPTION
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By �-1'"c.,
_
Boundaries Unlimited, Inc.
SCALE: 1"=
5-
D 'occ -Tests
923 Cooper Avenue, Ste. 102
Glenwood Springs, CO 81601
DATE:
FILE:
1�'
tele: 970.945.5252 fax: 970.384.2833
SHEET:
BOUNDARIES
UNLIMITED INC.
Consulting Engineers
June 30, 2005
Garfield County Building & Planning
108 8`h Street, Ste. 201
Glenwood Springs, CO 81601
Re: ISDS for Budges Resort, Garfield County, Colorado
BUI Project: Budges ISDS
To Whom It May Concern:
On June 28, 2005, Boundaries Unlimited Inc. personnel observed the construction of
the ISDS for the Budges Resort, next to the Flat Tops Wilderness in Garfield County,
Colorado. One 1000 -gallon septic tank and 24 standard Infiltrator units had been
installed in a trench configuration. No backfilling had taken place. The contractor
was advised to install the inspection ports at the end of each trench. Other than that,
the system was installed in conformance with the intent of the design. If you have
any questions, or need additional information, please feel free to contact me at 945-
5252.
Sincerely,
BOUNDARIES UNLI
Deric J. Walter, P.
Project Manager
Cc: Jack Harrison
923 Cooper Avenue Suite 102 Glenwood Springs' Colorado 81601 Ph 970.945.5252 Fax 970.384.2833
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