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Home My WebLink About01237 G ARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945.8241 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT ,k? 1237 a building or use permit. Owner H. P. Hansen System Location 2 miles north nn 101 road off highway R2 Licensed Installer owner X000 , . Conditional Construction approval is hereby granted for a - �40 --- ialton ' 1 1f'1 (d S4 L 44 u - + -. (af -n1 cfA�V.ti� XXX Septic Tank or Aerated treatment unit. / Absorption area (or dispersal area) computed as follows: Perc rate of one inch in iS ---- minutes requires a minimum of 7.7 9 sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms -4 x / 7 1 sq. ft. minimum requirement = a total of i I / 6 sq. ft. of absorption area. May we suggest t 1 y (1 3 l x _3 / L /8 k b Z X 3 __ .. � C - Date -. - d� (� ( R e----- Insppector / ..) iH. 1 -- -3t'l4. .4 ( .f- t - - l , art': /PP ,o etc olo4 e o n 7// C fet-c = / `` h 6 , • _ ,A A eq_o,,,,, 7gX= .037s8�e:tife FINAL APPROVAL OF SYSTEM 27 :wi 8 / u /2 �-fele ,:wit No system shall be deemed to be in compliance with the Sewage Disposal ws until the assembled system is app d prior to er- ing any part. (�!�\ Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. Proper materials and assembly. / / /� / [ Trade name of septic tank or aerated treatment unit. / Z 5 O q fi/L • '--+�/' . c • v ` Adequate absorption (or dispersal) area. h ,1• 70 X 3P1 ""¢ e1e ep Al t 4' /fie ( — el- C C._ Adequate compliance with permit requirements. 0 '' Adequate compliance with County and State regulations /requirements. }} _ / OOthe i r , e I Date- - - - -_7/ / y/ 9s- Inspector 1 �i r Wt./ _ 1 !7 � G 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 111, 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 1, Petty Offense ($500.00 fine — 6 months in jail or both). / Applicant: Green Copy Department: Pink Copy 7 ss ?7 S; G - /If2Ffci - ()woman', Coo %trica� - -- IiONE APPLICANT _5;46t- — — - -- — — — ADDRESS PHONE ------------ A CONTRACTOR Mil - -- — _ -- - -�- -- . PHONE , ADDRESS — — IS P MIT FOR: I ( Few installation ( ) Alteration ( ) Repair F.tt ;•.h c•c;•:,vate c_hrets or report showing entire area with respect to surrounding areas, tc.pegraphy of area, habitable buildings, location of potable rater wells, soil i,e colation test holes, soil profiles in test holes.. LOCATION OF PROPOSED FACILITY: County _ a/4.,QF7elP _ -------- - - - - -- Near. 1.- hat.City or Town (Iei BAV hat __ Lot Si ze /OS /!te. Legal Description '-t *n .n /O 3 /1r� .•= ' - - - -- - - - -. WASTES TYPE: ( Dwelling ( ) Transient Use • ( ) Commercial lor Institutional ( ) Non - domestic Wastes ( ) Other - Describe: S/n%t /f €/Ebro/ .4- 3 13 JasoPs 2Q BUILDING OR SERVICE TYPE: _.— —__ Number of Persons Number of Bedrooms ( ) Garbage grinder ( ) Automatic washer ( ) Dishwasher - SOURCE AND TYPE OF WATER SUPPLY: (V well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 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 c011'IUNITY SEWER SYSTEM: ..1/7i/%CS Was an effort made to connect to community system? NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( LderS Tank ( ) Aeration Plant ( ) Vault ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration Toilet () Recycling, other use ( ) Chemical Toilet ( ) Other - Describe: FINAL D)SP AL BY: ( Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( )-Wastewater Pond ( ) Other - Describe: - -- — — • :,'islild ;S r -Sr ,iU i0R — — . ;S PER DM' If the s;;s'_:i is to he designed by a Registered Professional Engineer (},'i'E), state rate of ;:!scrpticn in test holes shown on the location cap, in minutes per inch of drop in water level after Lu1LS Lava Len soaked for 24 hours: SOIL PERCOLAIION TEST RESULTS:; Minutes _____ per inch in hole No. 1 Minutes per inch in hole No. 3 Minutes _ per inch in hole No. 2 Minutes — 2 per inch in hole No. __ ac.{ fress, ; nd telephone of RPE who rude soil absorption tests: - ---- - - - - -- ---------------- --- - - - - -- Game, address, and telephone of RPE responsible for design of the system: • Applicant acknowledges .that, -the__coropleteness -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, informationand 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 2 ly /tv Signed PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY t sS Apo* 'Lh`A ?Mgr - v 0" F{ruy 8 v gil fifr °r 0 . 03,4 sPfii+1s I oat o °� � f Ofc 601/ Phi t her Os hr / 15 v i 0 4 • • �9 hi 1:.'q /:(.) lIF}i' Ir InclU'e by ,:icasurud location of wells, springs, potable water supply li;.es, cist3rfs, buildings, property lines, subsoil grains, lake, water course, stro :r., dry gulch and show location of proposed system by direction and distance from d. ;el11ng or other fixed lefcrcnce object , and .:dditicoal subrissVos in support of this appl ication.cuch.a data, plans, specifications, statements and cunuil two' Ls. • , to • coin ky a ffa ( AC-- • f- , f 4t1>tt A 4 . • • • p ^',Tester PERCOLATION TEST DATA � Address -- �D f �t.�pe�� 1�[dfc Profile hole W — .. + • i u"`^."L • TEST HOLE P1 TIME (Min.) Level Drop Level Drop Level Drop 47 0 / If Or U 6�� 10 y (t A t/ Y11 / 15 p ? �/ 11 �i i l / /l 6 20 p l " _/ 1, 25 7 34 ,% t'P c '' !13_ 30 i re 4 8 cam" re' 35 40 45 50 55 60 Percolation Rate � minutes per inch. )(4)(