HomeMy WebLinkAboutApplication- PermitV
Owner
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue:
Glenwood Springs, Colorado 81601
fdaar W. Gassman
System Location
DeBeaue
PERMIT # S
(this does not constitute
a building or use permit)
Licensed Contractor
owner
* Conditional Construction approval is hereby granted for a %S o gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in ,j minutes Sc O sq ft.
absorption area per bedroom
# of bedrooms 02 x _2 ".e.) sq. ft. minimum requirement 3 ;;.5d4a oee,,, a a /3 r``
May we suggest (i
Date '47� /9 7J
FINAL APPROVAL OF SYSTEM:
Inspector
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
1
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
y, Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
I;Ir'
Date LO O b ? Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 68.44.4, CRS 1963, amended 66-3-14, CRS 1963.
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 no approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the permit.
S. Section III, 8.24 requires any person who constructs, alters, or installs an individual sewage disposal
7111 system in a mariner which involves a knowing and material variation from the terms or specifications cot'-
tainfid in thea application" permit commits a Class I, PettyOffense 8600.00 fine - 6 months in jail or
Al( 3
botic
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM**
Owner: F/55y gn5 5 777 F%
Mail Address: 5--J/ g 4, rb Y I d ?IC City: 65,0 rid To„, 1"onZi p: 8'is a 1 Phone: JyJr-r7 7
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW
Attach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable buildings, location of potable water wells, soil percola-
tion test holes, soil profiles in test holes.
1. Location of facility: County e-if)-F,'e L d City or Town 9 E OFA u E' C404 .
Legal Description Lot Size
2. No. of Bedrooms X Septic Tank Capacity 7 5-'0 Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well V Depth 5-A Other Depth to first ground water table
4. Is facility within boundaries of a city/town or sanitation district?
Fees Paid $
Date / — X76
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system?
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes per ch of
drop in water level after holes have been soaked for 24 hours: i 5 z /—
7. Name, address, and telephone of person who made soil absorption tests:
&/2i107 -Cf
8. Name, address, and telephone of person responsible for design of the system:
Vez 'tel/T
9. Express permission is hereby granted for the inspection of the above property by any
member of the Garfield County Environmental Health Department and/or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Environmental Health Department.
10. I have been given an opportunity to read the Individual Disposal Systems Regulations of
GarfieldCountyand-I hereby agree to comply with all terms, conditions and requirements
included therein.
-- ' — 7
., '/�
Date r" gnature of Owner
(TO BE RETURNED TO HEALTH DEPT.)
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PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAKS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE RETURNED TO HEALTH DEPT.)
a3OR 3 8 e9.3I'E 1334.87
let
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(S Be 47' E 40.08 C1+a1he)
S 89" 47'E 26iw�'\
NE10COR.TH.
''- 667.44'. 667.44'
13 87'
NW4PW4Otc. 33
98 16+; -PM
PAL
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L TRACT 1104
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TRACT 103
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214-
(N 89' 36 `so''W
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{Se89.28y�'E 20.02 Ch; ns)
389•t7'3i E. • r333.73r
NOSES
BEARING SOURCE WAS
CALCULATED FROM
INFORMATION ON OLD.
SUPPLEMENTAL PLAT.
ALL INFORMATION SHOWN
IN 1) IS FROM L.O.
SUPPLEMENTAL PLAT.
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S 88"3FT4"E /A/310.82'
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$W4$w' 5EC. 33
-r4s, K9ew 41
TRACT 105
(44.45 ac-) tsICKla}c1
frank 'logs. en 61.0 rla4
s..i fu la da4•,.
"-1
PdLedin. 2
W ` SW SW..See. 33 E'S!e7
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(S 89" 25'E
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20
(440.0.,:, r-.. (660.860 )
SURVEYORS CERTIFICATE:
I hereby certify that a field survey was conducted, under
my supervision during May, 1974, of the property shown
hereon; and that this plat Is a true representation of
said survey; to the test of my knowledge and belief.
Luther T. Musgrove, L.S. 10386
NE CdA.
TR 105
MMEMMilaiMaffili
o tso• toe'
SCALE: f"'■ 400'
L.egand
O F...,4 BFtisr Cer..
Co SET REBAR X g,._1
• SET REB4R P.OQL.
Chs+•• = 6G0.
ZE✓/ffO ,!Glow P .eeELS
.S or. /2, /97¢ ,, 2, 3 /
1rnWFV rQ
P"PT OF Pn. 3. 4 33
T6S, R9RW of the 4th P.M.
GARFIELD COUNTY, COLORADO
FOR
MR. DAVE NUN?
DE BEQUE, COLORADO
rr( 31 ROAD
;RAND JUNCTION,
,rMUST 214, 1974
RI(
MUSGROVE
SURVEYING
COLORADO
PRONE:
• 303-434-7089
a
FILE: 74-04-14
I
i
er:
Ar,
Yi
SEPTEMBER 12, 19714
PROPERTY DESCRIPTIONS
Omni Armies. Osb. SIMPI
''\•.t 3.
blipItems MI. 434411011
File: 74-04-20
/PARCEL 1 - W2NW4Si Sec. 33 T6S, R98W of the 6th P.M., Garfield County,
Colorado. Said parcel being within tract 104 of said Sec. 33, and containing
20.515 acres, more or less.
PARCEL 2 - W2SW4SW4 Sec. 33, T6S, R98W of the 6th P.M., Garfield County,
Colorado. Said parcel being within tract 105 of said Sec. 33, and containing
(20.225 acres), more or less.
4
PARCEL 3 - E2NWhSW4 Sec. 33, T6S, R98W of the 6th P.M., Garfield County,
Colorado. Said parcel being within tract 104 of said Sec. 33, and containing
20.515 acres, more or less.
PARCEL 4 - E2SW4SW'4 Sec. 33, T6S, R98W of the 6th P.M., Garfield County,
Colorado. Said parcel being within tract 105 of said Sec. 33, and containing
(20.255 acres), more or less.
NOTE - area shown in parenthesis ( ) calculated from information on G.L.O.
supplemental plat.
-*4041*7 _
Luther T. Musgrove, L.S. 10386