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Home My WebLink About01911 Tr' Nrrritfittit. " "galls ' 444,0 1; "'',h4w t ! GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Street Suite 303 Glenwood Springs, Colorado 81801 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT +=' 1911 a building or use permit. Owner Raytnond Solowitz System Location C.R. 216 Rifle Licensed Installer ___ owner Conditional Construction approval is hereby granted for a /P. 3- `c gallon - -. Septic Tank or _ Aerated treatment unit. Absorption area (or dispersal areal computed as follows: Perc rate of one inch in minutes requires a minimum of sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x (� /� sq. ft, minimum requirement = a total of /� K 0 sq. ft. of absorption area. /2! A ) R /tn r.r( 6_4,4 err ..3 or1 .1tnt C f.. / C - c l �_ Inspe or "} �� // I t May we suggest: t r. , i tq Date 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 �7 g any part. part. . ° _ Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. Proper materials and assembly. T ads name of septic tank or aerated treatment unit. • f ' , • . equate absorption (or dispersal) area. Adequate compliance with permit requirements. — — Adequate compliance with County and State regulations /requirements. Other Date 7 / 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 Sy stems 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 — 8 months in (ail or both.). Applicant: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by ounty Official: OWNER_ Old D O /OW In__ 15�� • DDRESS ()CT 22 L, Po PHONE :ONTRACTOR_ + DDRESS PHONE ERMIT REQUEST FOR: (x) New Installation ( ) Alteration ( ) Repair ttach separate sheets or report showing entire area with respect to surrounding areas, opography of area, habitable building, location of potable water wells, soil percolation est holes, soil profiles in test holes. (See pa a h.)) / OCATION OF PROPOSED FACILITY: County ( ? # j ,' e_ / ear what City of Town CV /7' t1 r ��_ Lot Size 2. GS egal Description J,n /- 4- /e.s4'q' 'ASTES TYPE: (>0 Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe r UILDING OR SERVICE TYPE: !r S / P.A.. !umber of bedrooms Number of persons ) Garbage grinder (/Q utomatic washer (Al Dishwasher :OURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek Jive depth of all wells within 180 feet of system: ( L & h o tv v (ip,c, J 1 l; 6� - b ) f supplied by community water, give name or supplier: /V / ;ROUND CONDITIONS: )epth to bedrock: O k n ow iepth to first Ground Water Table: U, ,-i 'ercent ground slope: )ISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: cc . .,�. las an effort made to connect to community system? A./-o "YPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ()<1 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 ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: ILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? Npr . , OIL 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. ame, address and telephone of RPE who made soil absorption tests: ame, address and telephone of RPE responsible for design of the system: pplicant acknowledges that the completeness of the application is conditional upon such urther mandatory and additional tests and reports as may be required by the local health epartment to be made and furnished by the applicant or by the local health department for urposes of the evaluation of the application; and the issuance of the pern;ftis subject to uch terms and conditions as deemed necessary to insure compliance with rules and regulations dopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies hat all statements made, information and reports submitted herewith and required to be ubmitted by the applicant are or will be represented to be true and correct to the best f my knowledge and belief and are designed to be relied on by the local .department of health n evaluating the same for purposes of issuing the permit applied for herein. I further under - tand that any falsification or misrepresentation may result in the denial of the application r revocation of any permit granted based upon said applicatio and in legal action for per - ury as provided by law. Mk ate 0--6/1 Signed �� L LEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • 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. Page 4 I / 7 07 r 4 oio frt —1 --- f) 177 0' .� I n SV, E P b i a 14 4. OOY f o 4. g P t 1041 3 64040' I s )10 U0OO ��( JA )f0 CV L W Jn � ' i. � I �T I 4 a ` ooi . 1. 8 ® ni3O CS � )•0Y U4 4 R ) ).w4. �� - )1 4 CA 0,91-2 �j� a 44 CP fw OY i 1,006 nOm e e 4.1 ___.__.. _. _._ o ( 4 ' ® hi 0 /1 i .a1 I I PITT- OO4- OO.O°o . / 541 4 ' 411 40 ••• t AOjOininp 2179 2179 — 053 T.6 S. -R.92 W. SEC. 5 S. W. ' n .O •.Paovco �x2.� - t✓ .4r71 .