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HomeMy WebLinkAbout00816 �� �� p �' !. 'V ' 1� t V * pr ";011 P 1 Y "' iI 1 'f "b mt a 1 r e M; t' r u 1w • QIm IIMiI4 a 1 01 Y4 w I ^' '* I I I ' 41 1 ° u u l � I I M S ( MP' ru Y W 1 I'dl I IG i t P $ ,? TA m 14 v X W I ^ I V " 1 '' I VI 1 f ..!'�1�.y, I�I w'. b 1 W N� q • I I 4 � I ' . M w R iv V �II� �I 1'' a 4 . ��rr '� i l a X �' tlll6 ., u � q I. r V j Skit -== _- - uuNaVi Po 1, 1 11 ry ^ 1 I a t t , ' it, P' �I m { 1 .� m T tl FI � I • u r °Uli WI i t, I ry % I I }r ^ �"d� UI I�Ir � tl I R I Ie IM I� y ��r V a I I i� u ld�V I dli'� 4 !r� ql 1II I'��.I �.. w r' V V � N ril ^ . • 'I'll I, 1 X r 11 u Wu 1,. n I I ryl 1 r — ib2�6ffi#ffim —'�"'" • 141114111 wl � A lu 1 1 f; l ' ' 1 s . . : _ JO... — a Se . . 1 I rill it ;.I i t r 1 ;Is A. l f 411, i I °H, 1 — I 1'u u Shl ho n r71 i 31 t s \ f P 'i. r4 11u I t _— ri l , Il wuII I 1 1 11 :IS •.: >S 4 :. P, r l t r 11.;1111 8 s ,A 1111 ' k -�siff h u ))1 1 111 1. UW v x „d'_' 'gIuAD11 1 5 1R, it ry .al H — 7 '4%. latIMSWIT —. _ __—. 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"/' .� 11 i71 ///c .S 5 / / zti7� ///��� (^D 1 / ^ !; -/ R f f Cr tt�%' /. /, % / eof 01 /• C'= mirsismsnantronceninthans _ - D lei!Y / 1 O L.�, // X. e l o f c- 1 �A >It~±s+ u - Sit er ..44, r,l c; y ��/ - Yuw.7 ill to m • , ,i 4M wn ll ofll id`s t .u 1 111 7 P 1, u I I04� fl,, I1 Oly mt' �" . � I 11, V ux ry ry � " r 1 V fIFk�tt P Y, Iwu I� YIr1. 1l,r �, sif Yi.:i 11 ` �, �1f i R r ) olt 1 It eft d ' " u 11 1] \C e'41eey� wnli'4uw Vow a 1M °I I � +S " " Il ,Nl �I� n d�i !, u s 41�:.; a , 71e� q +�I ' uVu " °hla°w .'�I.h I " .V ry tl M 47111 . °l� '� � V �. �,iylr - -•:: -._ This does not constitute a building or use permit. GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945 - 7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT N° 816 Owner Tom Blank System Location 0333 Lions Ridge Road - Lot 9, Lions Ridge Estates Licensed Contractor are • Conditional Construction approval is hereby granted for JD O /`L gallon L/. Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: /- Perc rate of one inch in — 2 r minutes requires a minimum of /�j G sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms 3 x OD sq. ft. minimum requirement = a of 120 sq. ft. of absorption area. May we suggest /2 Sc 7 . r c-r rt' / c9 � l�' �" ._ Cy f'' i. Date '' ' I / 4. 1 2 c? InsPec�r]..f 6Y. L" /'7/� r�� 5t.e.,b 7 FINAL APPROVAL OF SYSTEM: ((( /�/ No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover- ing any part. Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. tO Proper materials and ssemb - dl 1 �� P� S � f i Trade name f se tic tan r aerated tree ih t uni . GP Adequate absorption (or dispersal) area. e ¢ Z ©C' Adequate compliance with permit requirements. Qirc Adequate compliance with County and State regulations /requirements. Other Date S / h/'8O Inspect /` �jj !! O `! '�� RETAIN WITH RECEIPT RECORDS CONSTRUCTION SITE *CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au- thority granted in 66 -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 not approved by the Building and Zoning office shall automatically be a viola- tion of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Section III, 3.24 requires any person who constructs, alters, or installs an Individual sewage disposal system in a manner which in- volves 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). Building Official — Permit White COPY Applicant — Green Copy Dept. — Pink Copy _._..._.......mr�..... ....,. ....,. ...,............ Y....... Y..,......,.........,. u.................._......... ._.,.....__•______._....,,..,.. vrT1ce -JSt Page Two Fees Paid $ 7 co INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 4..- /6-77-) Owner: ' %e.. 4 tw.i4 Mail Address: Si /s-yy City: ,gs,, Zip: $lo // Phone✓` 31Vt 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 (see Page 3). 1. Location of Facility: County GARFIELD City or Town O 4,ct3, Legal Description .v7 - _ +a 3. / secd G Oc Lot Size „2 y fc± r . 2. No. of Bedrooms a � Septic Tank Capacity 4 � Aeration Unit Capacity 3. Source of Domestic Water: Public (name): Cecv at g -S sr Sz zr+ • Private: Well x Depth Other _ Depth to 1st ground water table 4. Is facility within boundaries of a city /town or sanitation district? 5. Distance to nearest sewer system: Have you attempted to arrange a connection with the system? _ If rejected, what was the reason? '—' 6. If R.P.E. tested, state rate of absorption in test holes shown on the location map, in minutes per inch of drop in water level after holes have been soaked for 24 hours: 7. Name, address, and telephone of R.P.E. who made soil absorption tests: _ • 8. Name, address, and telephone of R.P.E. responsible for design of the system: 9. Express permission is hereby granted for the inspection of the above property by any member of the Garfield County Building & Sanitation Department and /or such persons as they may designate. Any withdrawal of this permission shall be in writing and receipt acknowledged by the County Building & Sanitation Department. 10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula- tions of Garfield County and I hereby agree to comply with all terms, conditions and requirements included therein. 7,4 �� Date Signature of Applicant (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three , • •PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY • INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES • aJ� 1 (TO BE RETURNED TO BLDG. & SANI. DEPT,) 1... • " .7- r t ' • .• N. . • . C v -.• 1 (, ' : I "7 ' h \ t e`,-,-.../ -7; :P, -:I' .1 .L .. ' ' L - . ' 1 \ . . 1 2:' 3.),) 'a /A-, • • - -.11/4,6'bi r v'..t -- V■c".CW, ..2 ec• 1,...-(-1_-1 a:7_, (c5 10 . . 4 Slet 5c 04. 41;‘,. : . = 0; 4,4:. f it • a. : .• it 4 .r.t< ..c..ty,.7..z-, c:caiy. iczet :ikd •") .. . • 4t, 42 ., c4J4 rc..;5 .01 rj c: - ,.-xteC CJA ' t e t:.-t, 4 ;.• %I.:.' 501k 4-(4c 'VIZI.- N ., 1:1.,:i ca Coif. ,,,-).; ..--,,:iLLC 1 •s,,,.. t r _%, * N ..? ,5 . ,, - / 0" -'--- / ... •"/"‘ / / \a' i ii , ' . ,' 00), ._.----r 1 C ' -It 1-1 li • ‘. 0, , -,„ 'V .0 • / "C) 1_, / 4 E_ ' 1 4. (:). \ .$ ) ''s - - _ r I : „,- Y ., , , •. 9 r / _ , ..., i 1 - ,t. , ' • - ' ., \ .... ty, .,./ „ f ,• t . / 5 5 11 / 5 XI • ' 5 J-' !.....‘ 1 ::,/ 4 9 - C s N 1. ” • C.S - 3 ,D.-` • . ..- : E , -. ,- :5 ? I,— \ " / i ••.. • \ )■ ' 1-' L , " I • ..f.' _ 5 - i • T1 - .1. C- . , , . ) . -.' , • . i ti j f rd 1) , i - . I- .. ,U -s NI, - , . i ...._ C ;4_ 7 _ : • • .7 , 2.:"....•: ...Jr..: . 3:73 (-Lc. _ .. IVR --___ - ..'' ,. !1 T . 7 ----_, ‘ d: - ___ - '' • rz- , ..)% • - I ' \ .- ;/' ; t -.....________ (.(; \ • ..., -- — ) te ) E '_•\ \ ,‘. ' • ., \ '7 (- 5' -I i =is --. : ' ,\‘, 2 .% , 1 -3 4 , ,. e • \ Le : 1 :3..0 .. Tr- " , . •- . - 5, Y. "' -. r• ' 1 : t„ , , • . ( I , S •C \.1 , C.: :t ___ / '• ''....,9,.. . 1 ....% I I: —5 -1 .. ' • . :N %-.- -, .,,,.‘,. ."--.. • 1 - 1 , ,, , l -,'"•• N 1 ,.. ..,. , . .. - --.' - -1 . , .. _ s . 9 - - - it•.• ... ,..., : • • Application ' INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by County Official: OWNER . , . 773 or -red t/L_ C J Yr ADDRESS O J 3 3 L%ogs e A PHONE ?if O7 / (74 /11) k a CONTRACTOR tee y reetzf L' 0 ( k W) ADDRESS 04°O 6OX /07.aS AtdF1✓C PHONE WW3•07!/ ` PERMIT REQUEST FOR: ( ) New Installation ( ) Alteration ( ) Repair AR/770V 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: County Girti r /d( Near what City of Town Ca Lot Size 42,2 $ Ac Legal Description 0 3 3 7 C;,Nf R :olje Afoaet Le+ 1 WASTES TYPE: ( x) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Numb of bedrooms , Number of persons ( Garbage grinder ( ) Automatic washer (>() Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 4Vc e' If supplied by community water, give name or supplier: [ : cxisvp Lobe 4j+erv,t OW,t/,a/ j' GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (x) 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 ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? • SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) 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 department for purposes of the evaluation of the application; and the issuance of the periui't.is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies that all statements 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 under- stand 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 per- jury as provided by law. Date 3 - / '7 - 7 3 Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY Page 3