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HomeMy WebLinkAbout01227 a 1 i�ry mlaIT+py GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945-8241 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT ''1 1227 a building or use permit. Norris W. & Luella I. Johnson Owner System Location 0915 County Road 218 Silt Licensed Installer Boise Cascade Contractor will sub out septic installation - 'n/ 5Irbig Conditional Construction approval `js hereby granted for a 7' O gallon X Septic Tank or \Aerated treatment unit. Absorption area (or dispersal areal computed as follows: ,/ Perc rate of one inch in / 7' minutes requires a minimum of 3 74 sq. ft. of absorption area per bedroorn. Therefore the no. of bedrooms 2 x 7 ft. minimum requirement = a total of £ Geq. ft. of absorption area. May we suggest / , z ' , ' x v 3 x 3 deep - o I- - /g X 4 - 3 • Date r <.. . ? �`� 1 . Inspector , '� FINAL APPROVAL OF SYSTEM: / ° r T rt e' E �. 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. a , —" Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground 4 surface. �� e Cc /epoc.c cc c= ( �� c /� ti % Proper materials and assembly. <� z�•�ic C_t�.e: _5 r s rz - TC> T' S'- Trade name of septic tank or aerated treatment unitn-e//✓ 0YCS / OOO CoA i a teLXZ_ r9-c- Adequate absorption (or dispersal) area. /5/14 31X 40 Adequate compliance with pe mit requirements. Adequate cornpliance with County and State regulations /requirements. re) elp TlPrtei Other ©ie .."9-0.- it r te v.5 s Area -e, 00c �°i o f ��Coil ? „ac;resri-7 nert/,e' r0 Gi 6zs' �Jl S Pf.cJ -?ZOQE Dat• 416 iif/ F/E • Inspector cc-79`'Ctt) , /TG , m .61r pivc°7a 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 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 requireme Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a vii 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 whir volves a knowing and material variation from the terms or specifications contained in the application of permit commits a C Petty Offense (5500.00 fine — 6 months in jail or both). Applicant: Gratin Copy Deportment: Plnk Copy Sus aaauuaaaaaaaaaaa- aala.narana �.. INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION PAGE TWO OWNER MDRflA ' W' ve.118, Y Trn5f)t- ADDRESS O? 'S' GO Wily ROS-d 2)5r Sill CO PHONE 176 . 933/ APPLICANT R W. joh ADDRESS Ovs— rer jsid., 2 / S' _s or co PHONE /71 CONTRACTOR Bo i s CAS -d,. ( rry Po7feitj ADDRESS BOO "MI ti•6 14-41 Ave, Pl'4le co. PHONE 615.396'1 - IS PERMIT FOR: (y') New Installation ( ) Alteration ( ) Repair Attach separate sheets or report showing entire area with respect to surrounding . areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, soil profiles in test holes. LOCATION OF PROPOSED FACILITY: County 0 a rf1+e/S Near .. what ;City or Town vri / T Lot Size 5`74ri'es Legal Description $04 of SWS c. 7 -14vp. 65.R,v &%3w. 64 P11. WASTES TYPE: (X) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe: BUILDING OR SERVICE TYPE: Pone Number of Persons ?.- Number of Bedrooms ( ) Garbage grinder (x) Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (>n well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: f5f f1 If supplied by community water, give name of supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: -4 Hitt Was an effort made to connect to community system? A/o 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: OO Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: .: ' A PAGE THREE �y l . WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ND SYSTEM IS DESIGNED FOR GALLONS PER DAY If the system is to be designed by a Registered Professional Engineer (RPE), 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: SOIL PERCOLATION TEST RESULTS: 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 permit 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 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. Date 90 CLaJ, '} Signed `74,' vcti� i11 � 1 4 �!7 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY • o� _ •-!' S 77'40'e Or 87 ✓0' \° _ 346'03 40 L 53.4/ A11- I t I ` 537 /94•.39 �o,�„ \ S68'/940G /86. n 0 //4 f � (2.4. \ zo s A • SA✓i SH4 \i • J \ N S29'29E ' 220./.9 014 ,� \O r I S Ac. \ f, A l (2.5 Ac') (2.5 Ac. t) sc./ beet. 1 • J . CJO. /G I SCAte - /'• /00' 7/6 V I / ¢53.0 i (/82. S 89'OZ29gig v S .�'2 p 6`06334/7 - y 04 %>A0 .,�'LC C IL Pi ie �� SEC. // 77 Co S, R. .92 AV o r /he G C-4 A',41. GARFIELD COUNTY, COLORADO 1 A tract of land situated to the SW *SW,I of section 2, Township 6 south, Range 92 west of the 6th Principal Meridian, Tying Northerly of a County Road as constructed and In place and Southerly of the Ware and Hinds Ditch as constructed and in place, described as follows: Beginning at a point on the Northerly right -of -way line of said road whence the reestab- lished section corner common to sections 2, 3, 10 and 11 of said Township and Range bears S. 88° 47' 20" W. 453.03 feet; thence North 681.30 feet; thence S. 77° 48' 20" E. 27.10 feet; thence S. 46° 03' 40" E. 33.41 feet; thence S. 37° 35' 20" E. 194.39 feet; thence S. 68' 19' 40" E. 186.69 feet; thence S. 29° 29' E. 220.19 feet; thence S. 01' 02' E. 230.16 feet to a point on the Northerly right -of -way line of said road; thence S. 89' 02' 29" W. 455.22 feet along the Northerly right -of -way line of said road to the point of beginning. The above - described tract of land contains 5.00 acres, more or less. ROBERT D. SCARROW Registered Land Surveyor Certificate No, 3317 tl 1 '4 PAGE FOUR PLOT PLAN AND DESIGN FEATURES: Include by measured distance location of wells, springs, potable water supply lines, cisterns, buildings, property lines, subsoil drains, lake, water course, stream, dry gulch and show location of proposed system by direction and distance from dwelling or other fixed reference object, and additional submissions in support of this application such as data, plans, specifications, statements and commitments. /s /5 To 6� ft/✓�w 5ys FaR A ve.W Hcvse -' 414 WoRK 15 f h� c 0NT» -° Tinto," L3eise Cas�nd� PgFT nOn- GAR466 74tr " cisreA t i 15o c7 it We-II /o7 r Weir PRoR• N� 79 FT ,1 Srrrh PN9"- e, N.2. /' F T , fa WkTe4 5u s- ,v+ . J u ' W EL , L � c . b fry l ' - 91 l ' - 911 Ho 19. • ..F Date 1L' 3 Y Tlster r • PERCOLATION TEST DATA Address Mtti { Joi4nS C 4/ z/8 Profile hole `CP.1 / Soil Io 1,..4 TEST HOLE W1 N2 N3 TIME (Min.) Level Drop Level Drop Level Drop 0 7 57 6'4 7 (/-- 5 7 .i 1 g 7P) 7 9 �L 10 Ce — % – 7 , !t. / & 3 4 15 Q l 3 4 8 ' h l> /4 20 £ 3 /a 't % k /'f" 1 74- 25 fl // g' ��i 6, (> 1 `- 30 , t - P4 / P / 7 �f 35 40 45 50 55 60 Percolation Rate minutes per inch. 5 o_ce//> c 5 74. • - tit/ z�.IDS/ • •