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Home My WebLink About01570 • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 PERC RATE )V344 - ' PERMIT FEE Glenwood Springs, Colorado 81601 CNLY Phone (303) 945 -8212 1, � This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT )V7 1570 a building or use permit. Owner William Ja Mal • System Location CD. Rd 154, Gleamed t3prSrigs Licensed Installer __ ___ • Conditional Construction approval is hereby granted for a gallon - - -. Septic Tank or — Aerated treatment unit. Absorption area (or dispersal are:) computed as follows: Perc rate of one inch in minutes requires a minimum of .. ft. of absorption area per bedroom, Therefore the no. of bedrooms x _sq. ft. minimum requireme • = a total of sq. ft. of absorption area. May we suggest: Date _ _ .Inspector FINAL APPROVAL OF SYST No system shall be deemed to b• in compliance with • Sewage l .oral Laws until the se a led system is approved prior to cover- ing any part. Septic Tank acc: s for inspection and clea - i n : within 12 "o ground s rfac or aerated access ports above ground surface. Proper P materials a d assembly. • Trade name of septi.• tank or aerated t at -nt unit, Adequate absorption .rdisp• . area. Adequate compliance wit permit requ' ements. ✓( \`{`V Adequate cornpliance with County and State regulations /requirements. UU Other Date -- -- - - - -- -- Inspector -- -- -- -- - - -- - -- RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE `CONDITIONS: 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter 25, Article 10 C.R.S. 1973, Revised 1984. 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 violation of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Any person who constructs, alters, or Installs an Individual sewage disposal system in a manner which Involves 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 • INDIVIDUAL SIWAGE DISPOSAL SYSTEM APPLICATION Approval by OWNER County Official: William J. Mallory -- ADDRESS Box 400 El Jebel So. 81628 PHONE 963 -3060 CONTRACTOR Owner ADDRESS PHONE 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 Garfield Near what City of Town Glenwood Spring Lot Size 1.88 sores Legal Description Traot in Lot 20, Seo. 1, T.7S.,R.89W. WASTES TYPE: ( x) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Strsn Steel Building Number of bedrooms 4 Number of persons 4 ( ) Garbage grinder ( ) Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (x ) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 125 feet If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 1 mile Was an effort made to connect to community system? No 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: ( 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? NO Page 2 iSPIL PERCOLATION 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. 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 s 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 ' legal action for per- jury as provided by law. Date 7- 22 -87 _ / 4%-� Signed � �� PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY \ /C c� 0)p " $2' moeILE \V �c 6e HDm ! C �` 9/ fl LDR') (�� -- = OR op t eS },Ome5 • Pag 1 ___ ` 9 Permit N? 891 CHARGES t" Name of Applicant �' 111 an ' • 7b i Percolation Test $50.00 f Amount Paid $75.00 (includes final inspection) I Permit Processing Fee $26.00 s e Septem Date Paid er 8, 1 0 ' Check RtK�e% Ft1 Cash ,Casnier- s Toni L 'Sherwood �— � Money Order ALL CHECKS ARE TO BE PAYABLE TO GARFIELD‘COUNTY CLERK AND RECORDER. Clerk & Recorder 7 Receipt White Copy Applicant — Green Copy Dept. — Pink Copy ! f r � �4 ; t y "1r d x 4 : ' k �... pkg.. �r.i� F� $� �2 r' fig,g s k ` 1. • •' � r�_C ) Y � � �i " sl:L1Yi9L i r • • 1 4 I., • S 1r � r �•¢ ,. �. b ; v r, � This does not constitute { • ' `, =.ti a building or use permit. • GARFIELD COUNTY DEPARTMENT OF E NVIRONMENTAL HE 2014 Blake Avenue L. r r Glenwood Springs, Colorado 81601 ,v ,q � Phone (3031945.7255 ' VIDUAL SEWAGE DISPOSAL PERMiTi; 891 r 1� , t , t r ,r. a. , •I t 11 . "' ‘t,,, W f t i1 r ' F r 91 i l r r t yY d : r l ; Nilli v. Ma } ) ' . k . Location Tract in Lot.20; Sec. 1, T. 7'S, R. " o ° ut'b y C olton ' s : ad Contractor Conditional Construction approval Is hereby granted for a • { gallon • , i Lo Septic Tank or Aerated treatment unit E { .' • la Ik Tr area (or dispersal area) computed as follows d 1 t "" J. , 'p+ / � sr '% ' Pero rate of one Inch in minutes requ tres a minimum of t fr sq. ft• of absorption 'ea per bedroom. ..7) . • Therefore the no. of bedrooms _42.-- x 7S sq. ft. minimum requirement ■ a total of .7JV sq. ft. of absorption area. " May we suggest /2 )( 30 X 3 . Date �� /g1 I 1 IL•�•• :AL k APPROVALOF SYSTEM . 4 0, ; 4, � � ' - , ! 7 r u " No system shall be deemed to be In comPllan with the Sewage Disposal Laws until the assembled system is approved prior to cover- °sang 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. Adequate absorption tor dispersal) area, - W { � d v' Adequate co permit requirements ; d{ w Adequate compile 'Mk',th County and State regulations /requirements.'e ; ) Other gl '''^': i`r;':i F ' : Date Inspector RETAIN RECEIPT RECORDS AT CONSTRUCTION SITE :ONDITIONS: °* 1. All installation must comply with a qulrements 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 wh i n- 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). Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy