Loading...
HomeMy WebLinkAbout02081 '-- I*we ro 4 COP ei '773 0 r L-L WPWR"r. .r,.er w-a o+v4i' I if QARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N- 2 0 8 1 1 109 8th Street Suite 303 A is Parcel No. Glenwood Springs, Colorado 81601 I Phone (303) 945 -8212 I This does not constitute t , INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY 0348 Summit Dr. t It Owner's Name Michael E. Watts Present Address AAIQ,.CRR.. 210 Carbonda}•one_ 963 -2246 t System Location 0419 C. R. 250 Silt, Colo. g t Legal Description of Assessor's Parcel No. 2127 - 254 - 00-035 Sac. 25 T. 5 S., R. 92 W. SYSTEM DESIGN p ../ f/'�.� Septic Tank Capacity (gallon) Other I. / be,) � Percolation Rate (minutes /inch) Number of Bedrooms (or other) V-- + Required Absorption Area - ee Attache git Special Setback Requirements: Date / `/ I nspector >-- C-� I I 1 .. -'�! ' C - A . - t FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer 1 r'b/ 1 V- 6 41 1/M 7 A/ 6 Septic Tank Capacity /7 0 V h Septic Tank Manufacturer or Trade,Narf ie • I PL 4Q A A./c-- &ICl'C Septic Tank Access wittrni " k ace t ' ; it Absorption Area /! A/ % A i Absorption Area Type and /or Manufacturer or Trade Name - 2 ' NFiInP.fl 7Z3,IQ I Adequate compliance with County and State regulations/requirements Other � I Date v � � - Inspector �` a 1 . ; r RETAIN WITH RECEIPT RECORDS AT CONSTRU TION 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. 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or 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 (8500.00 fine — 8 months In Jail or both). Applicant: Green Copy Department: Pink Copy I Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by • County Official: OWNER af(' /f.QFA_ T L/47715 ADDRESS .1/4 r (; 267-) PHONE3IQ —F-22" 4 CONTRACTOR r- Pit is Jo 15 Qr/ly Z�l ADDRESS , ? /Ozt � , gg/ 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_ C4R /=i ,AJ Near what City of Town Slil (p-jpa/1Dr> Lot Size c Legal Description —. WASTES TYPE: ( ✓) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE:. /Nc..F: F 31.lItiy — Number of bedrooms 2 _ Number of persons ( ) Garbage grinder (V) Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (1/) well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 1),Ar Ff4 /62:, GRO/11,16 Viirrk yU t If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: -Vo 21 Percent ground slope: 5 z. r DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: .5 Was an effort made to connect to community system ?_ W TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (✓r 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? kf 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 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 permit 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. 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. j y Date i%/1993 Signed //6 ,4.�� � %7 PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY Page 3 La j ‘ \ • ` G. • �0. OP • i I 0 OC'%P \O c I I w I I O 1 - 1� 1 1 1 5 1 \ N f � Ot o G O m 0 O f + O O W m .4 ...„, O < p . / r N S R u - I Z _~_ F s • N N r 0 V N A r R ® t ® 8 0 N � cA 0 - 0 a . D 0 D / % \', Q a 0 /� O V / N C � W I 0 v\ e g Adjoining tlt t ' I' FFtc rR E-4,-.L :'. far MoVCt / ea PRE i 1 r / 'E ))ITGN pct TANK o 0 L ( � a 3 3 a Mi elnaen 3 4(AnjOemZeit 1 1 ( 1 If / -j43 -_ /"in 0 rm- 4 t \`X: /0 ,r v q t3 (AVE 10 a ��Ati 1 `,« - � -(' � ,�D .,n:., t 3'` v i 3 a ma `\. k © W 0C. A ® ; 1 ...A.:11 30 © f z % f l/ 4 ' - vy 3 6 ^ vC? v \v E c'' ciS\ , Y1 ok 4 S i / I ,V S 11 / ....,, \. AI SI12 INFILTRATOR CONTACTOR FW.aper Dispersal A(0.5) A(0.6) A10.6) 1'CIMC BCD Bedroom Area Trench Mecca lied Pieces Trench or Bed 13. ATP ROOMS - 1 r FT* 19 Pieces 5 1 247 ? 82 123 7 1413 11 140 9 2 141 2132 94 141 0 169 9 169 10 3 423 141 211 11 254 14 254 15 4 563 1E38 202 15 33E3 18 330 20 6 1 270 90 135 7 162 9 162 10 2 154 309 103 154 El 1135 10 105 11 3 463 154 231 1.2 270 15 270 17 4 617 206 309 16 370 20 370 22 7 1 292 97 146 13 175 9 175 10 2 167 333 1 1 1 167 9 200 11 200 12 3 500 167 250 13 300 16 300 10 4 667 222 333 10 400 21 400 24 e ... .: 0 21 - ..1. 0 HI / 10 11:1 / — TI - - 2 179 356 119 • 170 10 214 11 214 13 3 535 178 267 14 321 17 321 19 4 713 23E3 356 19 420 23 420 26 Y . 9 1 331 110 165 9 1913 11 190 12 2 1139 3713 126 109 10 227 12 227 14 3 567 109 2134 15 340 10 340 20 4 756 252 378 20 454 24 454 27 .` l) 1 16 9 209 11 209 13 Q 200 398 133 199 ' 11 239 13 239 14 3 590 199 299 16 359 19 359 21 4 797 266 3913 21 470 26 4713 29 - -- 122 '3 10 219 12 219 13 2 209 410 139 209 11 251 13 251 15 3 627 209 313 17 376 20 376 23 4 E336 279 41E3 . 22 501 27 501 30 -- 12 1 302 127 191 10 229 12 22'7 14 2 21'7 436 1.45 219 12 262 14 25E3 15 3 655 210 327 17 393 21 393 24 4 1373 291 436 2'3 524 213 524 31 - -. 13 1 3913 133 199 11 239 13 239 14 2 227 454 151 227 12 273 15 273 16 3 6E11 227 341 111 409 22 4119 24 4 909 303 454 24 545 29 545 33 14 1 413 1:3E1 206 11 240 13 2413 15 2 236 471 157 236 13 283 15 203 17 3 707 236 354 19 424 23 424 25 4 943 31 471 25 566 :30 ;566 — 427 1.42 213 11 256 14 256 15 15 1 3 13 ' 2 244 41113 I163 244 1 293 16 293 113 <'. 3 732 244 ' 366 ' 20 /139 23 439 26 4 976 325 40E1 26 506 31 5136 35 16 1 441 147 221 12 265 14 265 16 2 25.4 504 16E1 252 13 302 16 302 10 3 756 252 3711 20 454 24 454 27 4 100E3 336 504 27 605 32 605 36 -- 17 1 455 f52 227 12 273 15 273 16 2 259 520 173 260 14 312 17 312 19 3 779 260 3911 21 46E1 25 460 20 4 1039 346 520 20 623 33 623 37 ._ 10 1 460 156 231 12 2E11 15 201 17 2 267 535 178 267 14 321 17 321 19 3 1302 267 401 21. 4E11 26 401 29 4 1069 356 5715 29 641 34 641 3(3 h •it +*;'` . ` 1 i 4 , _,ALL.` ' i. 14+ 1 ? .,%: ). " ` 4 .,. ' , 1 ) + 1 . 11 �"k I I )1; i.),/ . ,fr st..= .%, 4*, ��� ) )�� ‘ A. .y ` t , i • qq 1 . f -., r , ff -�. r Y' N. s v y P ` , fir 1 . .. N \ • y t: .2+_ a, r t 1 �. T ♦ ♦VV + 1 , a 'C . . , . •� * _ 4 , QCsYt • am' - ..,.. k'? *. . . : j t ft 4?4, _I __ . __ __ : i ;, , SedlrG.' - - _--M ,:e.'..... :'`ri v . P .i 9 a rd. ..y.±4..y.±4.1 " ., � ' i .y ? ` ✓ ..�+' = r �< - y.�1_ •• I li ea. 7 C • ^ .,¢ - TS tom y as z t �� 3 Liy, • .. .W ' .+S'" ..� $t -" 3 � '-.k N • „ r: ;' t.`4.‘ Z C •L {'.•• • S. S'. ' ` t . va s • ...i.5.4..., ...„__.. , _ A , ' h ., . E . • - y `•M M31 ` - - ..... ` er } ', -fle : to s : e?y1 • ' • i ,4-; -it .,ti .- rf jc!" s $ 4 . %1Y . y R !.t,.. •a;'19 C ` i i >.• _ --4 - i 4 as lt. s e c +9y,{y ra 3 } : % ., ,`.1t,' h �, t w S9 1 '�J ElcS )4t� • /j� �i, ke t ,% ii �, 0 an pK � ; . , K } f sa, . t "Lv • u ' y ar= ,,.; < i dt i . Y t d t l4r5 t a$1"``$ i v ? ssa, saa Va b i Sit .w f 9 COPELAND SHIP TO A �. 14- 6 • CONCRETE INCORPORATED , y ? re z e . o �+ ,2- y . o Manufacturers of Precast Concrete Products — `��}�` Also Distributor of Related Items 28803 U.S. Hwy. 6 Rifle, Colorado 81650 //,�� "�f� 625 -1112 OLD TO Oft-f, L :t-(; ('(23 YJ r4. 'J / e c � ,�2 .tr- 4+- 3�; �- e( r -c` Fes • ,5'l6 ,S" , ' t. to 0 4 1. ATE • • RESALE MDSE. RETD. JOB NO. P.O. NUMBER :iISTOMER NO. • • PERSON CALLING JOB NAME �_ '_ %' W EIGHT ITEM Otv DESCRIPTION UNIT PRICE EXTENSION Sli Aped �/ % ) --' • GI -,k t__ .Il. e7 11Q • ./ . 1 - "/ 2 • r" 'r00 j 0 i ;Z t ue 6 - .5 3, 52' a ,y : 25 ,_0 MI X . /U t i,.1, a e_ I% y -7. -L A BLit {f': s •'> DELIVERY CHARGE 6, g,OO W A R R Y ON ABOVE-LISTED MATERIAL (INCLUDING NEW MACHIN' -, PARTS & SUPPLIES) IS LIMITED T•` AS P• OVID ,BV THE MANUFACTURER, COPIES OF WHIC FARE AVAILABLE UPON REQUEST. DRI��� 'GUSTO j�'S SIG e RE V / " S t ' STATE TAX / GAR F I E LD CO. TAX III THANK YOU TOTAL 15 /o 'I7; CASH A FINANCE CHARGE OF 1t % PER MONTH (WHICH IS AN ANNUAL PERCENTAGE RATE OF 18 %) INVOICE N? 76 t' WILL BE ADDED TO ALL ACCOUNT BALANCES THAT EXCEED 30 DAYS.