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Home My WebLink About01379 • 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 1 379 a building or use permit. Owner Henry T. & Linda L. Willison System Location 39057 Hwy 4 & 24, New Cnctle Licensed Installer Owner * Conditional Construction approval is hereby granted for a 1 a 000 gallon %X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in /0 minutes requires a minimum of 2 P sq. ft. of absorption area per bedroom. Therefore the no. of bedroom 3 x 2cp sq, ft. minimum requirement = a total of l�'r�q, ft. of absorption area. CE 3O (/t /CJ &'- YrC /3 fl -roc- c' /S- C -t#t )O® -S-'/ .5 GL P 7" " " May we suggest .Z)eref t> 'Vl' / O'ce s'vc°& e i,n' a /, 437+e,e, Date / / / —may Inspector , -z.0 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. C7 l/ Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. O j Proper materials and assembly. /_� ,// q / O t< Trade name of septic tank or aerated treatment unit. fit'l"""'"" ,�0 J,/ L Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. • Ubc Adequate cornpliance with County and State regulations /requirements. Other Date r9//e-S Inspector 12/4/1.,,, « RETAIN WITH RECEIPT RECORDS A �'ONSTRUCTION SITE *IV `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: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by 1r 1 \ County Official: OI CR 11 envo 1 -� Lty,.n. L_. Lot ADDRESS ()3'V 0•rrcir l 1 OA - Sp- Co . PHONE ( - Pic - c CONTRACTOR-,,,, ADDRESS PHONE PERMIT REQUEST FOR: (✓f 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 Ga Near what City of Town , C SA - Lot Si e e _ • Legal Description L4., �0 • WASTES TYPE: ( ✓f Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Number of bedrooms ? Number of persons 3 ( ) Garbage grinder (✓f Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: t wry If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock: 4 Depth to first Ground Water Table: &b Percent ground slope: t DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: a ,,,, L0,5 Was an effort made to connect to community system? VI 4 -vAt(a b t TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (v/'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: (v1 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? j/U . Page 2. SOIL" PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) r; Minutes per inch in hole No. l 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 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. 4 Date S Sig i iilligg s5 „-t . ^ PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY h l- Ok \\‘sor SC Het 0 ( S-6 l ,tin, /\ ST D. c ian. • � u 4�� J tA) ' 1 J �- - -rp 5 117' a40 s 70 5. /i 72 6 - 6:' Page 3 - _ r EXHIBIT "A" land, situate, lying and being in the County of Garfield and State of 1I Colorado,to -wit: A parcel of land situated in Lot 2 of Section 4, !Township 6 South Range 91 West of the Sixth Principal Meridian, IiGarfield County, Colorado, being more fully described as follows: I 1' i'Begining at the North Quarter Corner of said Section 4, also being Northwes Northerly linehofesaid8Lote2; thence2S.E00 I ,degrees 25'51 "E. 428.96 feet along the Easterly line of said Lot 2; 'thence 5,89 degrees 34'09 "W. 147.15 feet; thence N.70 degrees '50'30 "W. 1252.09 feet to the point of begining. i The above described Parcel No. 2 contains 7.24 acres more or less. The above described Parcel No. 2 is subject to the easements or right -of -ways of the Tompkins Ditch and utility lines, all as constructed and in place; Also together with a 30 foot road easement as shown on the attached map. ( The bearing source for the above described parcel is N.00 degrees !25'51 "W. between the Southeast and Northeast Corners of said Lot 2.