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HomeMy WebLinkAbout01313 - GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT ' 2014 Blake Avenue ri Glenwood Springs, Colorado 81601 I i ' Phone (303) 945.8241 a ` INDIVIDUAL SEWAGE DISPOSAL PERMIT 4. This does not te 13 i 3 s a building or use se perm permit. Owner Jonnie M. Roes and 4tha K. Walter System Location 3200 County Road 92 • Silt (Rifle mailing) Licensed Installer finer * Conditional Construction approval is hereby granted for a 1 .000 gallon XX Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in __am minutes requires a minimum of •4<S - 4» sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms 3 x ' .Sh sq. ft. minimum requirement = a total of /.36� A x:55 2c0 — ..n /O e�z,,S of .�./ �o sq. ft. of absorption area. May we suggest � O'er / 5> -/ e a /1 e /fr,Xlo /ir)1 / ©.0 ,aiX 9.x' / 5c� .„ d c—f' Date 7— . -a-c.2 — "S Inspector 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. -0 (/ Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. /,. __ 0 t Proper materials and assembly. OK_ /� Trade name of septic tank or aerated treatment unit. c2 p e /ct t ,c/ -I LIDO Q « / r 12 - c 0. A' Adequate absorption (or dispersal) area. / )J !/ / t �s . �a Ile Si, l� _— Adequate compliance with permit requirements. tPl l C [ v \ Adequate compliance with County and State regulations /requirements. Other Date 14 , e7 _ — Inspector ' .ei — ( RETAIN WITH RECEIPT RECORDS A '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). Applicant: (inn', �... _._ -_ Pink Copy - •••••ua- au•aar Hppi lcatrUff INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by r ---- County nn County Official: OWNERSoN►Jic ►f.&ss en-HA W 4-440-101C. ADDRESS 934 QR+C rictO sr. CsRBMoDgtC Coto i PHONE q6 3 - 1fl3 1 s-z) O CONTRACTOR Sp vn E ADDRESS PHONE CD PERMIT REQUEST FOR: (x) 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: County G A R rJEt b. Near what City of Town 5 /47 - Lot Size /0 ACRES Legal Description SE /i ,W w 'i/, SEC. (2 ) TSS, e 9 9i 414-.57 1 4 *4 P<�.v.YN. CABne.0 ��d0 cty WASTES TYPE: (X) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: I-(oas C Number of bedrooms - Number of persons - ( ) Garbage grinder ( .1 Automatic washer ('"j Dishwasher 3/�2/A/-6 Fo.e /2 ��0.��1z�!A L 9 /,r -- /� T�2 /VK /IJ�pL[lirt'7t'.e- SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( --) spring ( ) stream or creek Give depth of all wells within 180 feet of system: — If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: 3' DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: '- Was an effort made to connect to community system? NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( , Q 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: (x) 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? &1p Page 2 • I P of' are:et -C:- • .....) >• '-.G;:' - 1 ,, t 1 T c ‘ ? • .---- ...-- i . e / ) , '''3-------- a e -' ,.-• — .. „„_. .-- • , i• - -- . -- ...- ...-- . -'-' -- - - 1 - ----- ' ..._ -- E.4semeici' -Cm aecess 1 . 1 1 1 i ■ _____ _ .._ _ _ —÷ ! ski Qa pole- (5 e•asenien .' ,c 4 etedels 1 I 1 • . 1 i d Z 1 4 1 cs, O iti c l, q 0 l l 3 i c re 5 ..), a No 4' 1 1 . i ■ )' 1 5 Ilectc Foto\ ers .7; . .- le, ion I r.,. • i x 1 ,---- -x- 1 i ..;.+•ecte tAi +14 0 A/ Cs' ' polel 1r c-nti Pole. .- ._ .. ' SOIkPE'1fCOLAtION 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. Nans address and telephone of RPE who made soil absorption tests: Nama:,address and telephone of RPE responsible for design of the system: r App* flt acknowledges that the completeness of the application is conditional upon such furillr mandatory and additional tests and reports as may be required by the local health de patient to be made and furnished by the applicant or by the local health department for p of the evaluation of the application; and the issuance of the permit is subject to sue%tenns and conditions as deemed necessary to insure compliance with rules and regulations acted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies thatlll statements made, information and reports submitted herewith and required to be s by the applicant are or will be represented to be true and correct to the best of *knowledge and belief and are designed to be relied on by the local department of health in mluating the same for purposes of issuing the permit applied for herein. I further under - sta*Jthat any falsification or misrepresentation may result in the denial of the application { o location of any permit granted based upon said application and in legal action for per- ! j provided by law. Da 27 S 3 Signed 4 .it..irscc- PLE DRAW AND ACCURATE MAP TO YOUR PROPERTY Page 3 p i _.. C r a A K., n N y t\ oi R R I i C. • 9 0 _)' -; m -n° — — pN � , 0 o - , - . 1 O yy c n t ' o SiA t z N n n, T Ut /3-' nt a na F - -3 x A U z \ \ \U I ni Res, 1) 0 T- ���111 11 fi r n r 0 7°, e J, 0 a Y N t \� ' ___ / Fctack- \\- /a`/ cX 4 ' ✓E 70 /Q[NCn, e MTF • f'Ec0 "&<.% \ 0 0 _ c am/ - _� b "y O e x a