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Home My WebLink About01855 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 Glenwood Springs, Colorado 81601 d Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT N 1855 a building or use permit. Alan & Ke» Curtis Owner - -- - -- __. System Location C.R. 170 Licensed Installer Prank Bishop Constructio • :. f_.t kc it ; r', (r ., v'^n S : 12594, * Conditional Construction approval is hereby granted for a /000 gallon ' i - 1,..- +k Y s• z ' • Or o ✓e) 1, e' t 1 1 TV . . t -' . Septic Tank or _ _Aerated treatment unit. Absorption area (or dispersal area) computed as follows: - ' 7 f ) pp L� J( r. t F I r "r • r J _ -i,7, r ��V H,.,r Perc rate of one inch in / 7_ minutes requires a minimum of 2- '3 V sq. ft. of absorpti�onn areaper bedroom. Therefore the no. of bedrooms 3 x �' 3 f sq. ft. minimum requirement = a total of / / 41 q. ft. of absorption area. / r May we suggest: ^ S t? _ T I e. a t p i r ' 3 e I, `�, z� t / ei k 3 7 61 ) 1 _ (,:: `, )) f ��r r Date / /� / C) . Inspector 64- / `G7 - r e:e 4 , ,.. , , ,: A•� ow r7 .) 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 part. /.2 J 0 — Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. V Proper materials and assembly. �_ �+ p Trade name of septic tank or aerated treatment unit. 1 0 - ii, J lJ' Adequate' absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. _ Other /,��(��,,� Date —/-1 ^3d ` 70 -- _ Inspecto L W """" 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 (all or both.). Applicant: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by Co my Official: )WNE 111/AA e 16flin (,,.a -vts 7• q1 ( 1 op )DRESS Pn k „ .?R ?OR 9 if ('o 0'42R PHONE p �a' ? )NTRACTOR - )DRESS PHONE ERMIT REQUEST FOR: (X) New Installation ( ) Alteration ( ) Repair ttach separate sheets or report showing entire area with respect to surrounding areas, )pography of area, habitable building, location of potablel,water wells, soil percolation est holes, soil profiles in test holes. n� (See page 4.) )CATION OF PROPOSED FACILITY: County lope r,E,.f ear what City of Town C f r,„naAte Lot Size 4.27 Ac. :gal Descri ption 04T,4gI IO ,11 Ir.r I'1 .t cot It con. ik t, .- i 7 SOC4 w • gAniaeL ■••a.c•r r.F Tar (e” t pkinc,pgL 1t li 4 AA. ( l ARC A / ( cn ��,.v.VS�I l n( 9.0.0r, 4STES TYPE: ()( ) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe JILDING OR SERVICE TYPE: ' %,nrncr- umber of bedrooms 7 beire ( 3 ) Number of persons F >, .e ( y ) ) Garbage grinder ( )() Automatic washer (X) Dishwasher OURCE AND TYPE OF WATER SUPPLY: (x) well ( ) spring ( ) stream or creek ive depth of all wells within 180 feet of system: y&/)Fl Fp... n wait A& Syr, f supplied by community water, give name or supplier: ROUND CONDITIONS: epth to bedrock: epth to first Ground Water Table: ercent ground slope: ISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Li, rmF . ilagek as an effort made to connect to community system? A.0_ YPE 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: INAL DISPOSAL BY: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration , (X) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: ILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?__ Nc' 1 C 1L 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. nie, address and telephone of RPE who made soil absorption tests: me, address and telephone of RPE responsible for design of the system: plicant acknowledges that the completeness of the application is conditional upon such rther mandatory and additional tests and reports as may be required by the local health partment to be made and furnished by the applicant or by the local health department for trposes of the evaluation of the application; and the issuance of the permit is subject to ich terms and conditions as deemed necessary to insure compliance with rules and regulations lopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies iat all statements made, information and reports submitted herewith and required to be ibmitted by the applicant are or will be represented to be true and correct to the best my knowledge and belief and are designed to be relied on by the local. department of health 1 evaluating the same for purposes of issuing the permit applied for herein. 1 further under - :and that any falsification or misrepresentation may resul$ in the denial of the application • revocation of any permit granted based upon said application and in legal action for per - iry as provided by law. �J Ite Signed ()J7j =< y`. .EASE DRAW AND ACCURATE MAP TO YOUR PROPERTY CA+tlr Cgcvg Roses '' k0 170 PMOtAMA Ca.'61 r • 3 o , ; � 'RoPerry Page 3 1 • 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. P(wper t„.% e der ofts,y %40. 16at1 " 01i%4 • 2u S y ge s =%€1, Olislasto ei b Mtn Qww....•& W eN. _ if Ow.,, tSo 'non Si I ' A 4 � N • d Page 4 F Approval INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION by County Official: OWNER A /an E KF. M 1 ) Garb ADDRESS PI P, 4 & -SS Co %fl PHONE 943 18 CONTRACTOR_ ` 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.) l� LOCATION OF PROPOSED FACILITY: County aRFiF.Gf) Near what City of Town______ pf r,tikpa /6 Lot Size 4,27 4c. Legal Description Q,TUj1tt0 ,n for 19 •f so S9 ca,..,,cw, 7 snc.4.-a, ,Ranr $7 ,..,csr n F TdF lo pkInci pat Phl,R, hi n,1 , l e aRl • , rrt.n l . ,u.n.4 1 C n10 0 Fa l)^. WASTES TYPE: ()( ) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non-domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: PF.4,0r.,.cc Number of bedrooms 7 74 n ( 3 ) Number of persons Erma ( t/ ( ) Garbage grinder (A) Automatic washer (X) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (x) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: YAM Few.. srre9 watt OspTVt %ti 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: A,,.,-,. e„A .r 4p n. Was an effort made to connect to community system? A)p 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: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration , (X) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF TFIE STATE? p j 1 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 Minutes per inch in hole No. Nance, 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 pernittis 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. Date Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY CAE4 CREEK Roso to.. Re 170 PMOQAMA los $ � 'RoPERTy 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. PR.opernj Gina IA N - ,t. %4RI&ATk.« bis«w . 20 (>IbsD S� fitf, M 1M MwM eF P wc[Li.+� WAIL 73 en - 2YY # '/So'FRvn. 5416 _■-••-•' • I A IV $ I Al 1 Page 4