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Home My WebLink About02161 to i 1 ., dA'n>jlg CO SANITATION DEPARTMENT Permit . 11 1 :. \ (. �• , c} .tc' � \ ., 109 8th St eat Suite 303 A r'a Parcel No. . , \ ... - '1 GlenwdothSpthkgs, Colorado 81601 Phone (303) 945.8212 �� y - ' ,_ . This does not constitute • INDIVIDUAL SEWAGE DISPOSAL PERMIT \ a building or use permit. PROPEIITY `' '"� t 1 Islet Irwin ,- ` s. 595 High St.. Denver 921 -9941 ) . Owner's Name Pres ent Address Phone System Location a •-- i .1 \ ° ` d t84 Sun King Drive, Glenwood Springs 1 1 i " i M Legal D I, ioebf Asses§ Parcel No. Y. �` �. `' Vm.0.^ .A R *-\.M.„14._17 '? SYSTEM DESIGN �✓ .t3 o ptic l /� itkpap itY(9allon Other 1� S G t • N gy m.. - < r .. ..-y � 7 M + + Percolation\Rete nutes / inch) umber of Bedrooms ( or other) 2 ' r / eTfk 3. J , .e. -c- /tea• -Q , Required �baofption Wit r Attached 7 u P R , r• err— 2 Cp - ci4 Special S.tback Refinements:` 9 Nn Ai Go o V � �< a'v' t?"✓"' 2 ]3 0P I Date 3 — 9 inspecto `�.✓ b C u 4 0 4 - _ FINAL YSTEM I;.ISPECTION AND APPROVAL (as installed) Call for nspection•(24 hours notice) Before Covering Installation III S System Insta r u 99 ptic Tank Ca ,achy Septic Tank Manuf turer or Trade Name • Se ` p t'c Tank Access witftie 8" of surface Absor Lion Area \ , , Absorptio Area Ty) and /or ManufatKer or Trade Name Adequate com 'en. ce with COiptY1nd State regutaUQnahequirem is Other Date .... ° �ti Inspector t, \ CI ,, \ .. RETAIN WITH RECEIP RECORD 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. 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 ($500.00 fine — 8 � \ ) months in )ail or both). Applicant: Green Copy Department: Pink Copy , 40 e Cl4A.L.EO 3 -(4-97 LEFT "(534c1 t. GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit I 2 1 6 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81801 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY )drfle Irvin 5' ") 1i1:' t., D r'• "S /J Owner's Name Present Address Phone System Location 02E14 fun F. hit Drive, ermvooc' Legal Description of Assessor's Parcel No. SYSTEM DESIGN ,7/ - c), i Septic Tank Capacity (gallon) Other 4, 1 Percolation Rate (minutes/inch) Number of Bedrooms (or other) ' Required Absorption Area- See Attached , i r " , /,_ Special Setback Requirements: 96( Inspector ,J N.h`)/ < t, 1 Date �� -- � P - C44 FINAL SYSTEM INSPECTION AND APPROVAL (as Installed) CaII for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name 1 Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and /or Manufacturer or Trade Name Adequate compliance with County and State regulations /requirements Other Date 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 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 aviolation 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 ($500.00 fine — 8 months In Jail or both). \ Applicant: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by 1 ,—)PANES b2w if1 County Official: OIJNER pes ADDRESS Si /- IIco- S TRO&V 'pct.! vu?, PHONE 303 3213541 0 CONTRACTOR_ H02Jf /'D 0 ADDRESS PHONE PERMIT REQUEST FOR: (l/(New Installation ( ) Alteration ( ) Repair Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes. (See page 4.) LOCATION OF PROPOSED FACILITY: County CM-grief-TA Near what City of Town 3(444./44o SPuJq$ Lot Size tL , ACie 1 Legal Description 44 N£ / AL St "h Stcrlo.,i 2! Twr '1 Sov7W gAnice PJV✓ WASTES TYPE: ( //) uwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe _ BUILDING OR SERVICE TYPE: /ZUrDetvi7N Number bedrooms umber of persons__ ( Garbage grinder ( 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: 7 at tLt. D-- A+✓imp m Vy cr If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock:_ 'O Depth to first Ground Water Table:__ Percent ground slope: g of DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: j0ooi Was an effort made to connect to community system? Na . TYPE OF INDIV UAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( 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 TIIE STATE? N1/4-0 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 Mo. 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 permft,i3'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 niy 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 DJuJ93 Signed PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • Page 3 IV • • s t'-� -e 2 ; or , ' ' - °-5' . 2:16' » is2 ) :3 f 4 ' 5" S' i 3 - 3 0 4 1, I- S 5 Q v T� b, si - 4 f ho 0 _. a7 "_3 =9n env � J e / -/ o G S P Adorn; G -ay -97 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2806 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Owner's Name .Tames Trwin Present Address 284 Sunking Drive, G.S. Phone 945 System Location 284 Sunking Drive, Glenwood Springs Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) 2 Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and /or Manufacturer or Trade Name Adequate compliance with County and State regulations /requirements Other Date 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 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 ($500.00 fine — 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT • a. INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION ,VNER Tk.v,<s ,H ADDRESS -199 S'"^ k;1 Or '✓•e PHONE (Y —7SO p.,,,, NeQ....., CONTRACTOR L. 4 rr•y Vvl C -"^rt• ADDRESS 6bt oq rL Gw S PHONE 9y 72. PERMIT REQUEST FOR ( ) NEW NST.ALLATION ( ) ALTERATION (PAIR 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: Near what City of Town Crl cnwxdi S Size of Lot Legal Description or Address 0o)( inn e ,i , WASTES TYPE: (ViScELLNG ( ) TRANSIENT USE ( ) COIVLMERCI.AL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Number of Bedrooms Number of Persons ( ) Garbage Grinder ( ) Automatic Washer ( ) Dishwasher SOt1RCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the'Community System? .A ite •1 n i r• suir•d ti se unities th.t indi _te the fo !wino MINI_ 'M di tan • . Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN. GROUND CONDITIONS: Depth to first Ground Water Table Percent Ground Slope • PE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: , ) 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? PERCOLATION TEST RESITLTS (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) 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 ofRPE who made soil absorption tests: ereJ;ay ly nzrn, '1 Name, address and telephone of RPE responsible for design of the system: l-T, h Caws }r. F„ , Trr arc1C 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 purposed 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 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 understand 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 perjury as provided by law. Signed Date PLEASE DRAW AN ACCURAIE MAP TO YOUR PROPERTY!! 3