The URL can be used to link to this page

Home My WebLink About01396 GARFIELD COUNTY BUILDING%ND SANITATION DEPARTMENT 1l,, 2014 ke Glenwood Spr ngs, Colorado 81 1 t y Phone (303) 945-8241 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT , ''t 1396 a building or use permit. owner Mr. & Mrs. J. C. Bec Sysie}n Location 46103 Hwy 6 aLENWOOn SPOS. CO. N e . r Licensed Installer _ Owner * Conditional Construction approval is hereby granted for a 1 gallon X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: "Perc rate of one inch in S minutes requires a minimum of / sq. ft. of absorption area per bedroom. E.. �� Therefore the no. of bedrooms 1 x /,P/ sq. ft. minimum requirement = a total of 1277 sq. ft. of absorption area. May we suggest 1j / Y ce" e,.— /y �� / .Sai - Y"rz C 0 /1 '� O c t = 7. Date / /_3 cy 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. ��'" Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. t Proper materials and assembly. aft1 name of septic tank or aerated treatment unit. (C A Adequate absorption (or dispersal) area. e � - -- Adequate compliance with permit requirements. `r Adequate compliance with County and State regulations /requirements. — -- Other Date i % - V Inspector 6 / 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 fa 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 (5500.00 fine - 6 months in jail or both). Applicant: Green Copy Department: Pink Copy ' County Official: `1 . INER /19�. ,nt - �/ _ e . ADDRESS -ra Io 3 , c yh (o f/ G ONE � ( CONTRACTOR 6244-0.0 4--- ADDRESS PHONE /2c„ PERMIT PERMIT REQUEST FOR: ( ) 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 1 .nz -- - _LS Near what City of Town , r - _,sway, r 'nyz4r Lot Size , Z & #9 -c-i2c-rs Legal Description WASTES TYPE: ( &fling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe BUILD N :OR SERVICE TYPE: _ .tr e _ dot Numb& f f bedrooms dumber of persons ( ), arbage grinder ,d( tomatic washer ( Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (, ?) well ( ) spring ( ) stream or creek Give4epth of all wells within 180 feet of system: ,1452,e) if sp plied by community water, give name or supplier i -z— t GROUtl ONDITIONS F r� > s' 6 x � 4 Z- l Ant' - r.G1, -� tt. Dept ')aiedrock.,, t a _ fise 7 rn ) ; a, RA } � 'f t I . Depth ,to first Ground Water Table: " Ic n v Percent ground slope: /1P-4 mod DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: c S / L -� Was an effort made to connect to community system?" /tU TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( ✓)Septic Tank ( ) Aeration Plant ( ) Vault ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use ( ) Chemical Toilet ( ) Other - Describe: FINAL DISPOSA}-7BY: ( 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? tclU Page 2 • SOIL PERCOLATION 1LS1 RESULIS: (lo be compretee oy r<eyisterea rroressionei cnyrneer./ Minutes per inch in hole No. 1 Minutes caper 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 .pet*tt,4scsubJect 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 ' 1 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' ggal action for ;per jury as provided by law. Date re / / -eFe Signed a te-rx. PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY w kg 4 y . r l}.. j +�+ 1 • � !dl S , F' ' :11'41 1' • p a k'kP 3 in ` ,4 14 y' P Y -.4 -1K. 4 h•' ro - n ` ,t *iR' , N.}5'... W'Nf.{ dh .'�`t Q r '�r � '' t irCe44 r • • Page 3 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. • • • • • • , j r . i 1 1 � {� 1 v�� t �,� t N t .4E1 th { 74 fir •�„ ei..1;. .4.44/y ..? S ... # .. .L. • ,'". nd1. .'t'. SlO litk r�K es' *..6�a. ■ c ,p s S� .k' e r e t. c '� F , { C n fa- X I ) .off LZ� , J i 3 i f • Page 4