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HomeMy WebLinkAbout01606 Art GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT 'ti` 1606 a building or use permit. Owner Mike Knop System Location / H' OD. Rd. 294, Rifle Parcel A, , TO }V1BDS1 1 :un): t. Plat Licensed Installer ___ * Conditional Construction approval is hereby granted for a /©!n 0 gallon - ---)� Septic Tank or _ Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in 7/ _ minutes requires a minimum of ,_2 3 q sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms _j x 2c.3_.7_ sq. ft. minimum requirement = a total of 7 / 7 sq. ft. of absorption area. May'we suggtst: /2. 0." 1 � X 4 � p 0 5 X 3 �_ /e e t) n r i �y' 1,K �F U X ? 'de e F p , Date _ -�-"p 8 . Inspector ' FINAL APPROVAL SYSTEM: / No *stem 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. `VC Proper materials and assembly. O • \ Trade name of septic tank or aerated treatment unit. at,e y.`Q/ /2 S O .4/ 67,47c jc r e/ .,t /.. e Adequate absorption (or dispersal) area. /g 0 „Z S f ez`le C/ ' Y �, Adequate compliance with permit requirements. OK Adequate compliance with County and State regulations /requirements. - -- Other / / / Date � t'J/ G8 - - - -__.. Inspector RETAIN WITH RECEIPT RECORDS A 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 tine — 6 months In jail or both.). Applicant: Green Copy Department: Pink Copy } r INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by �17 NER /9 d ny) County Official: ADDRESS (og �nc <,,a PHONE 42C //9 CONTRACTOR Owns/ ADDRESS PHONE 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 G44_4 /f Near what City of Town r AR „1/c (c 43 Lot Size 2 AC4rs Legal Description ,SeC_ fo y 1 . 7 93 WASTES TYPE: (K) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non-domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Number of bedrooms 3 Number of persons 2 ( >) Garbage grinder (X) Automatic washer (5C) Dishwasher 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: Cri) c-( pjt GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? yeS 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 DISPOSAL BY: ( ) 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,oiG N n n Page 2 • SOIL 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 Name, address and telephone of RPE who made soil absorption tests: per inch in hole No. 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 suchtermsfandeconditionsnasf application; with 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. Date Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY B 714 e.cE836 •• EXHIBIT "A" • • PARCEL A A parcel of land in the NE4 of the 5E4 of the SWj of Section 10, Township 6 South, Range 93 West of•the 6th Principal Meridian in Garfield County, Colorado, and being more particularly described as follows: • Beginning at the Northeast Corner of said NE4 of the SE4of the.SW4 of said Section 10, a No. 5 rebar buried below the surface of the asphalt pavement of County Road No. 294; thence South 89 ° 45'32" West and along the northerly line of said NE4 of the SE4 of the SW4 a distance of 266.71 feet to the TRUE POINT OF BEGINNING of Parcel A, a P -K nail set in the asphalt pavement of County Road No. 294 and witnessed with a No. 5 rebar and cap marked L.S. 10871 set South 00 °34'20" East 30.00 feet from said P -K nail on the southerly right -of -way line of said County Road No. 294; thence continuing along the northerly line of said NE4 of the 5E4 of the SW4 South 89 ° 45'32" West a distance of 220.19 feet to a P -K nail in the asphalt pavement of said County Road No. 294; thence South 00 °34'20" East, a distance of 28.20 feet to a No. 5 rebar and cap set in a fence narking the easterly line of a 25' wide lane described in Book 509 at Page 197 in the Garfield County Recorder's Office; thence South 00 ° 34'20" East and following the easterly line of said 25' lane a distance of 367.50 feet to a No. 5 rebar and cap marked L.S. 10871 and set for the Northwest Corner of the Jehovah's Witness Church Property as defined by County Commissioner's Resolution No. 81 -33 and described in Document No. 311784 in the Garfield County Recorder's Office; thence North 89 East and along the northerly line of said Church Property a distance of 220.19 feet; thence North 00 ° 34'20" West a distance of 395.62 feet more or less to the POINT OF BEGINNING. Also known and described as: Parcel A, Johnson Exemption Plat Recorded as Document No. 359906. Together with an undivided one - fourth interest in Johnson Spring and Pipeline No. 2 as adjudicated in Case No. W -1838, Water Division No. 5; Together with the following non- exclusive, perpetual easements for the use, maintenance and conveyance of water and utilities: Easement for the purpose of providing electricity to pump irrigation water across that parcel of land described in Rec. No. 268438 and being 10.00 feet in width and 5.00 feet on both sides of the following described centerline; and