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Home My WebLink About01977 kfFit 1 . GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 109 8th Itre4t Suite 303 I' Glenwood airings, Colorado 81601 Phonl4'(308) 945.8212 This does not oonetitute INDIVIDUAL SEWAGE DISPOSAL PERMIT NR 1977 abulldirigoruee G1 , Owner Prank Dusts y System Location 2091 Panorama Drive, Pa Ranc$ea p f Vi Licensed Installer – Rick Clouse 1 f ,,. r ,. • Conditional Construction approval is hereby granted for e 4 j 6 C gallon v Septic Tank or Aerated treatment &nit.., Absorption area (or dispersal area) computed as follows: iP .i, i I ' Parc rate of one inch in .!? ‘"% minutes requires a minimum of 7 J sq. ft. of absorption area per bedroom. °l ^" Therefore the no of bedrooms 4 x // sq. ft� requirement m a total of . ' sq. ft. of absorption erect ` ' May we suggest: 5 Inspector L//r i✓ t/ Cr ' I h o ri II FINAL APPROVAL OF SYSTEM: II No system shall be deemed to be in compliance with the $ewage,Disposal Laws until the assembled system is approved prior to clover* 0 + :, i 'i,, Pii " Mg any part. I ° t , ,1 / vi Septic Tank access for inspection and cle within 12 of ground surface or aerated access ports aboveground +i ,i surface. 1' !r: Proper materials and assembly. ii . 111 II / 1 Trade name of septic tank or aerated treatment unit. 66 l 'i „” 3 6 ,,1 ; / ' " f'' r ' ) Adequate absorption (or dispel sail area. 1 ' s 11 J � / .0. -- Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. Other t if ii Date �, ,. 3 -/' i- Ins J..., -:_r , ,,.., c . r *..::..._. . , q il a6 x, RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 1 r 'r' "CONDITIONS: I 1. All I' Chapter 25, Article 10 ans. 1973, Revised 1984. " it 2. This permit Is valid only for connection to atruotu s which have fully complied with County zoning and building 'r" ii i requirements. Connection to or use with any dwellin Or structures not approved by the Building and Zoning office shall "l'hi ,: i , automatically be a violation of a requirement of the p'grmlt 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 i "'. terms eclfl dons twined application permit Petty ffense and material variation from the a ca nthea I P Pe Y i ($500.00 fine — 8 months In )all or both.). p h Applicant: Green Copy D"partment: Pink Copy . 1111 Application Approval y � INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION by County Official: OWNER .' F74 Y O o ADDRESS T .� o2G3Q rf] rn. GO. RIG72 PHONE ,20- (G��{ ( 191 ,I CONTRACTOR_ IZ is k kmit - ADDRESS Si I + PHONE PERMIT REQUEST FOR: (V) 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 (.a -tic(d r Near what City of Town Carr andloule, Lot Size ' • 71n /64-5 Legal Description /,.,'l" 33 /20i70, otPtici tfonxieQ S WASTES TYPE: ( V Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe LQING SE(tVIICE TYPPE:e- o. oe, Mel w ttril . KVMS� j m be i't. F✓ 'X &Number of persons ( ) Garbage grinder ()C Automatic washer (X) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: LAI k If supplied by community water, give name or supplier: Pau,,nrc+W,A 42s. 6,44 GROUND CONDITIONS: Depth to bedrock: On k h o r — Depth to first Ground Water Table: 1Jri ✓t o^^o yl C 10 0 Percent ground slope: S / U °�- DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Co c- - i 1 e S Was an effort made to connect to community system? 0 .. 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: (>Q 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? N o — , Sd'IL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) Minutes per inch in hole No. 1 Minutes per inch in hole No. 3 t 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 pernitti 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 N - 4 - 94 Signed 53];"/ PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY J/' • . I 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. \ k0 <<" \ROL 1 kit Page 4 r l' TO' qic ' ' ',r ai rr l, "-","71 r9r 1 , 1 " ,:'," 11 ^ -' ' !Ty: 7 tre744Ti Tr 44 74 . -:47:7 ,71 " l ‘ '' l ' 1 "`" 4 T i ' h , ,,,,, : ,,,,.,M ' t it il4Vir - Soilp 7 )0mr - 7 1 - 41 ''' , ' 111 1, 4 4.,, Tr ciiet->i, /At ,.. ■.^, -I , I ' 1 , iii w." "fl --''' ,. ligir. 4444,4kt ''4 4 1/4y VISIMI 1 I '''' •. " • ""r4“: i' f,' if T ' .1 ,,,.. t 4 .ortO il ' .'" 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