HomeMy WebLinkAbout02142 S GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N- 2 1 4 2
e 109 8th Street Suite 303 Assessor's Parcel No. i
ri Glenwood Springs, Colorado 81801,.
\- !II. Phone (303) 945-8212 t
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. 1
I
PROPERTY
7
Owner's Name John M Dsvilbis• p resen t Ad dress P Bo 1685 Rifl Ph one 625 - 3142 f
d
ft t
System Location 4401 Highway 13, Ris '
Legal Description of Assessor's Parcel No. 4
SYSTEM DESIGN $ c 1
0 fa 0 L S Tank Capacity (gallon) i Other F :
1 ri
/yr`• 3
A/' A '� Percolation Rate (minutes /inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached ll
Special Setbact Requirements:, s t 3
� � t � e
Idt Date 5 ^ 3 1 — `> Inspector ! r9'N
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) { Before Covering Installation Ill ;,
System Installer 5l1 I L. "- , f t' It
Septic Tank Capacity El 1-6/1" � T i/{ /s/ 4 / t� T l 1.. F t G " t l t . r 11 1� Y .> 1 / i t ii 1 ,
1 "ter.
Septic Tank Manufacturer or Trade Name I >" d" 1 � - ��'`�
Septic Tank Access within 8" of surface v 1
it
Absorption Area 71/4 r }
Absorption Area"Type and /or Manufacturer or Trade Name
3 8 ' -rte 4t 0 T .2 1 1.2-t..0 .C9_
Adequate compliance with County and State regulations/requirements L l
s r 7 7( P7A1k .yl' /N - A',C Otrnt /7/, is4- ,.: / /..•. /
Other I F.1 "WO/ r P.74,-; 4. ; PAL .. /4 ti�VT/ /h i
Date, ergs f '�1 inspector � )''?1�..., „.Yy, t .. 'J
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS: t
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.
/ ir 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- 'f F
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a iE c
requirement of the permit and cause for both legal action and revocation of the permit. z
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 (5500.00 fine - 8
months In Jail or both).
Applicant: Green Copy Department: Pink Copy q,�!
GI
• Application
7'' S,'• // INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
OWNER ' jb%71)44/ M Dpi'?) hi County 0 0
ADDRESS a qq tivA '( 13 PHONE 6,25-.3( ga- f ‘t 9 '
CONTRACTOR O 5,,3 A9 er _ ALT ADDRESS P1 - gel( 'toe C A-1- )e- PHONE 40),5
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
K C
e 4.)
LOCATION OF PROPOSED FACILITY: County r/'/'e //,r
Near what City of Town he Lot Size /P "Pre;
Legal Description / _
WASTES TYPE: ( �/) Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe -
BUILDING OR SERVICE TYPE: /4.14/: G/
Number of bedrooms 3 Number of persons !
( ) Garbage grinder (-1—Automatic wa r ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: - hl - ' e i
If supplied by community water, give name or supplier:
GROUND CONDITIONS:
Depth to bedrock: Y V AM
Depth to first Ground Water Table: A
Percent ground slope: A/
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: i',///P
Was an effort made to connect to community system? R/i
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( ) Sceptic 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
( ) Ground Dispersal / ( ) Wastewater Pond
( Other - Describe: /dud eur7/ Aeioderr ee o C See; 49A6061/
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF TFIE STATE?
i 1
f n' 4114
SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.)
Minutes Wyg per inch in hole No. Minutes per inch in hole No. 3
jlinutes _ per inch in of No Minutes _ per inch in hole No._
Nance, address and telephone of RPE ,h lade i 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 permft,is 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. 1 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.
�
j
Date e` / / �I3 Signed 1 4�P"
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
•
•
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
connitments.
•
Page 4
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August 17, 1993
Mr. Mike Devilbiss
4401 Highway 13
Rifle, CO 81650
Dear Mr. Devilbiss:
This letter is to inform you that you are scheduled for a hearing before the Garfield County
Board of County Commissioners acting as the Board of Health on September 7, 1993 at 1:30
p.m. for approval or denial of your request for a 1000 gallon septic vault.
You may set the septic tank at your own risk and with the understanding that if the Board of
Health denies your application, you will be required to install an approved leach field. If our
request is approved, the Board of Health will set a time limit that you can live in the modular
home without an approved leach field.
Garfield County Building Department will need your signature to confirm that you understand
the conditions.
Please return this letter to us with your signature.
Mike Devilbiss
Sincerely,
e0 :149
Art Hougland
Chief Building Official
AH /sa
•
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GARFIELD COUNTY
. • APPLICATION FOR BUILDING PERMIT ���
PERMIT NUMBER
Assessor's Parcel d Please print or type UA'LR 23%11
TO BE FILLED OUT BY APPL ICAN 'PLOT PLAN
- -- ADDRESS yya/ /NGywev /3( /F /f NOTE: Show easements, property line dlmenslo,
SUBDIVISION all other structures, specify north, and sire:
FILING Id LOT 0 BLOCK N nano. For odd shaped lots, or if space is
) TAX SCHEDULE 11 too small, provide separate plot plan.
LEGAL (SEC /TWE /RNG) N OF BUILDINGS NOW ON PARCEL '0-
NAME , _�V!) j USE OF BUILDINGS NOW ON PARCEL .$
A! NAILING /l I1 /�pp�c�l//tt ' ., 4 ,
g CITY CITY 1T � PHONE 64,6:j /9_L /
• NAME C1 C/ f
ADDRESS i$N CITY
F' - NAME . 000le . r —` 4, .. 7
ADDRESS
CITY eV
$ PACNE LICENSE e ' f i > � `� "-
CLASS OF IIORK be '
VFW ALTERATION ADDITION _ K
DEMOLISH REPAIR - MOVE 3p E" 3
7OBILE HONE (make /model) , r y"�' gym t
';.F. OF BUILDING,f$ yg S.F. OF LOT
p OF FLOORS / HEIGHT ,
N OF FAMILY UNITS 0 OF BEDROOMS .3 w lpD r INTENDED USE OF BUILDING WEB I t•� y ✓3 _ —�__�� � _
GARAGE: SINGLE__ DBL CARPORT: SINGLE DDL FRONT PROPERTY LINE
FIREPLACE 44:17,0 DOCUMENTS AT1'ACIIEh _ ST'REET NAME /ROAD NUMBER _
WATER SUPPLY ul Per CHECK IF CORNER LOT
DRIVEWAY PERMIT ^ —
_ DESCRIP ION OP WORK PLANNED P /Ci, p
SITE P7'JIN
BUILDING PLANS *4
SANITARY SEWER CLEARANCE ,- !,. t,,i . I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT i.� application and the above is correct and I
_cm= DOCUMENTS (specify) (g/ ;_ � „, agree to comply With all county ordinances
ands rays re lap' g b )ding constructii
in
T'VRE
FOR OFFICE USE ONLY
• VALUATION FLOOD HAZARD
PERMIT FEE $ /OO.— PLAN CHECK FEE $ CERTIFIED BLDG ELEVATION
TOTAL FEE $ SCHOOL IMPACT PEE $ 200. SPECIAL CONDITIONS
VATS PERMIT ISSUED _
ZONING DISTRICT PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY 2 ^1 _
TYPE OP CONSTRUCTION )/C//P flo0(ic'ti ADDITIONAL INFORMATION NEEDED
S.F., OF BUILDING S.F. OF LOT
MAX. HEIGHT /15Z ROAD CLASS. CERTIFIED BY COLORADO REGISTERED LAND SURVEYOI
SETBACKS PROM PROPERTY LINE: PRONT /00' t mr OR ENGINEER
REAR /COO RIGNTP 200' i- LEPTA Sop',
OFF STREET PARKING SPACES REQUIRED
0
APPROVED �e2 :I,Ir ✓_t f - ice M' over c `- - _ __ - -�
BUILDING iPAR :NT DAVE PLANN 'ARTMENT DAVE
DEAR SIR'S ;
MY WIFE AND I HAVE PURCHASED A 40 ACRE
PARCEL OF LAND. WE ARE CURRENTLY PLACING A MODULAR
HOME ON IT,( FIGURE 1 ) SEE ATTACHED. AT THIS LOCATION WE
WOULD LIKE TO PLACE A 1000 GALLON SEPTIC VAULT,WHICH
WE WILL HAVE PUMPED OUT AS NEEDED. I HAVE ALREADY
MADE ARRANGEMENTS WITH BFI TO HAVE THIS DONE.
IN THE FUTURE WE ARE PLANNING TO BUILD A
HOME AT (FIGURE 2) SEE ATTACHED, AND WOULD NOT BE
ABLE TO UTILIZE LEACHING FIELD OR SEPTIC TANKS PLACED
AT (FIGURE 1).
FOR THIS REASON I WOULD LIKE PERMISSION TO
PLACE A VAULT AND HAVE IT PUMPED OUT IN LIEU OF
CONSTRUCTING A LEACHING AREA.
THANK YOU,
MIKE DEVILBISS
7/1 0A4 e
.
Of S rvabes a . SERVICE AGREEMENT 0!_» :.w SO41716
et ' BROWNING - FERRIS INDUSTRIES n
ACCOUNT NO.: LOCATION COOE: 100
. LIJ, NEW ACCOU 0 NEW SERVICE LOCATION 0 REINSTATE CUSTOMER 0 CHANGE SERVICE LEVEL 0 OTHER CHANGE
•
• l/ SALESPERSON: • / r A. REASON CODE: / AA -
BILLING INFORMATION SERVICE LOCATION INFORMATION r `
CUSTOMER NAME: . _ S N. E VI
CUSTOMER NAME: 1. V I I Pik S r a n t IQ
L
STREET NUMBER: A a . • • STREET NUMBER: v
STREET NAME _' STREET NAME : - 1 4 -) '{ (3 •
CITY: -2 ; FL t STATES :_C -0— CITY: - Fy STATE: r L7
ZIP: SCE PHONE:( 30 )' l.� ? ZIP: $ 1 t0 50 PHONE:( c) ). _ _
CONTACT: - • . \ CONTACT: _
NUMBER OF INVOICES REQUIRED: 1
1 ACCOUNT CLASS : 1 AGREEMENT DURATION: I _J IJ II I I�M1( BILL FREOUENCE: 'MI C
LATE CHARGE CODE: W COLLECTION LETTER: L o' ) SIGNED AGREEMENT : 1 (YIN) ACCOUNT TYPE : I (
INVOICE CODE r! RECEIPTS REQUIRED: (YIN) APPLY TAX : N (YIN) CITY CODE : h"` 1 F • U fri
R
INTERIM BILL. : f! (YIN) : I 1 1
4 nit « tT'W7F : EQUIPMENT SPECIFICATIONS DELIVERY DATE:
' '�I . 01 FREQUENCY ROUTE:
i j' nunti I�� —_ x. (. SERVICE DAYS: S M T W T F S
II II r DISPATCH COMPLETED BY:
II. DATE: ell
` o230•0 0 ?et Pump
01 02
SD REGULAR OTYx$ Basic Service Rate -$ REGULAR OTYx$ Rental Rate .$
EE REGULAR OTYx$ Add'I Service Rale.$ pTYx$ Rental Rate -$
RS QTYx$ Basic Service Rate.$ • OTYx$ Rental Rate .$
V C
I R pTYzS Add'I Service Rate.$ 02 TOTAL: $
C I
EP pTYx$ Basic Service Rate -$
T OTYx$ Add'I Service Rate.i 03 OTYx$ Damage Waiver -$
I
0
N 01 TOTAL: $ GRAND TOTAL (01,02,03) $
0 OTYx$ P +D Charge -$ P.O. No.:
EA OTYx$ Special Occasions -$
R OTYx$ Special Clean Rate -$ P.O. Duration In Months:
TG $
I S $ Estimated Duration of Customers
MS Project in Months:
7 -
E TOTAL ONE-TIME
' n CHARGER ••fi�nn .T�
SPECIAL INSTRUCTIONS: it/LEJ /-,& -tom - - ;�
IF DAMAGE WAIVER IS DECLINED: I decline the Damage Waiver, and 1 understand by declining I accept full responsibility for damag
or theft on equipment rented from BFI. Initials
THIS AGREEMENT IS A LEGALLY BINDING CONTRACT ON THE PART OF BOTH BFI AND CUSTOMER AND THEIR RESPECTIVI
HEIRS, SUCCESSORS AND ASSIGNS IN ACCORDANCE WITH THE TERMS AND CONDITIONS ON THE REVERSE SIDE.
TERMS: NET 10 DAYS CUSTOMER NAME: ax1X. IP/ ea
BY (SIGNATURE): X ar. -Ar .
f.I f0'.TAT:5 ".f:a•f^SI, iu:.
NAME '. BROWNING-F SUS • IES SUBSIDIARY PRINT NAME & TITL _ S - II _ . I
A, l • 9 j� , ' t I _ EFFECTIVE CONTRACT DATE: g • 9! • q -R •
• 10188 • 619-S OF 1 q- 13F/ BF1260 -475 PT
ni 10.11 nnPV -- -
x $41,V
, •
of AUG 191993�
• - CAEJ 1 U.Li couty y
August 17, 1993
Mr. Mike Devilbiss
4401 Highway 13
Rifle, CO 81650
Dear Mr. Devilbiss:
This letter is to inform you that you are scheduled for a hearing before the Garfield County
Board of County Commissioners acting as the Board of Health on September 7, 1993 at 1:30
p.m. for approval or denial of your request for a 1000 gallon septio vault. A
You may set the septic tank at your own risk and with the understanding that if the Board of
Health denies your application, you will be required to install an approved leach field. If our
request is approved, the Board of Health will set a time limit that you can live in the modular
home without an approved leach field.
Garfield County Building Department will need your signature to confirm that you understand
the conditions.
Please return this letter to us with your signature.
yed Oder(
Mike Devilbiss
Sincerely,
\ Art Hougland
Chief Building Official
AH /sa
September, 1993 - Page 149
PROCEEDINGS OF THE BOARD OF COUNTY COMMISSIONERS,
GARFIELD COUNTY. COLORADO
September 7, 1993
ASPEN GLEN: HEAVY EQUIPMENT USE BEGINS TODAY
Mark Bean said heavy equipment that will move dirt will begin today at
Aspen Glen. Jim Wilson is the Contract Manager regarding this.
COLORADO TECHNICAL SERVICES, INC. (CTSI): MANDATORY VEHICULAR TRAINING
AND CDL
Regarding Dale Hancock's note about CTSI mandatory vehicular training,
King said Road & Bridge is set up to receive this training on Friday.
County Clerk & Recorder Mildred Alsdorf said Road & Bridge is exempt from
this; they need to take the Colorado Department of Transportation's
testing. King said Road & Bridge's Kenny Gardner, temporary employees in
that department, and the mechanics do not have CDL, but Ron West and
Marvin Stephens have CDL. Chairman Arbaney said he would think employees
with CDL's would be exempt from the CTSI training.
SNOWPLOWING
When King receives phone calls regarding snowplowing, he tells the callers
that they need to explore ways to help the County, and that nothing has
been decided one way or the other at this point. King will meet with RE -2
this week, and RE -1 next week. Commissioner Mackley met with Gianinetti
informally last week and discussed snowplowing. Internal streets of
subdivisions may not be plowed and school bus routes may be tightened up,
said King.
SOLID WASTE FEE
Steve Zwick said that if this fee is changed, the Public Hearing process
needs to be used. King addressed the solid waste fee increase's potential
problems in memoranda he included in his budget. Chuck Deschenes would
like to devise a recommended fee schedule by next week; King said he will __
have figures for the BOCC by then.
RIFLE MOUNTAIN PARK
Regarding Rifle Mountain Park, King asked if he was supposed to meet with
the BOCC or Don DeFord about finalizing the Agreement and problems with
the width of the road; Chairman Arbaney said the width has been worked out
and the Agreement is not finalized. King and the Rifle Chief of Police
looked at the road and agreed a "Parking In Designated Areas Only" sign is
needed. King gave the BOCC pictures he recently took of that road through
the Park.
ROAD AND BRIDGE RODEO: JIM MCBREEN -
King said that at the Road and Bridge Rodeo for employees, Jim McBreen
placed 12th out of 30 participants, higher than anyone from the County has
ever placed before.
CHANGE ORDERS FOR SEAL COAT /CHIP & SEAL: ROAN CREEK (CO RD 204) AND
CHELYN ACRES (CO RD 149A)
Road & Bridge had money left over from Energy Impact so King extended the
chips on Roan Creek another 1/2 mile, and also at Chelyn Acres.
Commissioner Smith made a motion authorizing the Chairman to sign Change
Orders for additional Chip & Seal on Roan Creek (CO RD 204) and Chelyn
Acres (CO RD 149A); Commissioner Mackley seconded the motion; carried. `
BOARD OF HEALTH: MIKE DEVILBISS,NAULT
Commissioner Smith made a motion that the BOCC go into the Board of
Health; Commissioner Mackley seconded the motion; carried. Mark Bean said
Mike Devilbiss is placing a doublewi.de modular unit on the lower section
of 40 acres and requests that a vault there be pumped monthly for one year
without using a leach field; a leach field will be built when his house is
built. Mike gave Mark a proposal from BFI Portable Services for pumping
the vault, and he agreed to install a light on the tank indicating when it
needs pumping. Steve Zwick read the design criteria for vaults regulated
by the 1988 Guidelines for Individual Sewage Disposal Systems adopted by
the State Board of Health. Commissioner Smith made a motion allowing a
temporary vault to be installed on Mike Devilbiss' property at 4401 Hwy.
13, valid from the date of installation through 10/1/94, for 1,000 gallons
and with a signal device indicating when the vault is full; Commissioner
Mackley seconded the motion; carried. Commissioner Smith made a motion
for the Board to come out of the Board of Health and reconvene as the
BOCC; Commissioner Mackley seconded the motion; carried.
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