HomeMy WebLinkAbout02164 •.: w•emaapRR+'+srV.'+ RR•��$,hA4 s� , �. wery+^v".^+'. vr. i. -m .... ....:... .r .. .. _.. .. ,
1 ;Al
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 1V: 2 1 6
109 8th Street Suite 303 A is Parcel No.
Glenwood Springs, Colorado 81601
Phone (303) 9454212
1
• >Pi" `(.. 7 :� �;, , u ( This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 111 y a building or use permit.
PROPERTY
Owner's Name J•S• Brosseau Present Address 4418 CR 154. Glenwood Phone_ 927-3431
System Location 4418 County Road 154. Glenwood Springs
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
,J6
Septic Tank Capacity (gallon) Other e.
Percolation Rate (minutes/inch) Number of Bedrooms (or other) 5
Required Absorption Area . SeeSee A
Special Setback Ai Requirements: J <. /3 c, p( 0 ,.
7 f u( ")`D� o f = /ri �AY< /yt
q f7�A /NT y"y Insp � �� �/ 4./0241P
Lip
Date 9/tea/ Inspector ,/r 20 r
r '
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 \ \ h ho ours notice) Before Covering Installation
system Installer % I N N j Ck y CM) /Ma/ P;
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 _. � � 9 a. JJJ```
Date /43/ Inspector ��,/s" ,j.�����'
• 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 — 8 "•
months in )ail or both).
Applicant: Green Copy Department: Pink Copy
Application
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
_ County Official:
OWNER N j r C• � / aOSSE/9�(
ADDRESS 'Vy // 'OGtn I Ed /s PHONE
CONTRACTOR_ e L2 /
ADDRESS v ' X /000 ,48s/9CT OOO /d2 /PHONE 9a -34
PERMIT REQUEST FOR: ( ) New Installation ( ) Alteration ()() Repair
Attach separate sheets or report showing entire area with respecfE 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 n (j/9/Zf /6L0
Near what City of Town i�enenn °c� c5/09/.//79,( Lot Size /Y/i/ ,ve,c-u'
Legal Description - ee € /f ice r
WASTES TYPE: ( i() Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non-domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: y _
Number of bedrooms 5 Number of persons of -f —
( ) Garbage grinder ( ) Automatic washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( )() well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system:
If supplied by community water, give name or supplier:
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table:
Percent ground slope: /
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 7 /mil/
Was an effort made to connect to community system? 4
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
p 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? — AA
•
•
• ,. •
•
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 permftis 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.
Date 12f/93 Signed tit_ — /
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
Page 3
Si
505- 982 -0837 THE FLRNCE COMPANY 081 P01 SEP 28 '93 09:46
Pest -It brand tax transmittal memo 7671 # of mass o 2
10 7 mm a Cttelkl A
" IreA r E QU Ge
tt , 9L? -SASI ° "' • 505 985• A8g1
" 3ca 921 -401) F". 50 c42.O5
A tract of land situated in Lot 2 of Section 36, Tp. 6 S., R. 89 W.
of the 6th P.M., Garfield County, Colorado, lying Southwesterly of
the Denver and Rio Grande Western Railroad (Aspen Branch) right -of -way,
described as follows: Beginning at the Southwest corner of said
Lot 2 whence the Southwest corner of said Section 36 bears S. 04 °34'
W. 510.80 feet; thence N. 04 °34' E. 303.28 feet along the Westerly
line of said Lot 2 to a point on the Southwesterly right -of -way
line of said railroad; thence S. 52 °36'28" E. 498.86 feet along the
•
Southwesterly right-of-way line of said railroad to a point on the
Southerly line of said Lot 2; thence N. 89 °55' W. 420.49 feet
along the Southerly line of said Lot 2 to the Southwest Corner of
said Lot 2, the point of beginning. The above described tract of
land is subject to a 60 foot right -of -way, being known as the Old
State Highway No. 82, also the county road crossing the Roaring
Fork River. The above described tract of land contains 1.46
acres, more or less, less 0.36 of an acre contained within the
highway and county road.
.f" .
COPELAND CONCRETE PRODUCTS RIFLE, COLO. 816$0
PNONN 996 -4817 'NONE 6251112 YARD 21/4 MILES
904 SOUTH LIPAN ST, EAST OF RIFLE ON NIWAYS 6 & 24
DENVER, COLORADO 80223
1000 Gallon (shallow) DRY WELL
w
Made up with ,2 ■ 60" performed sections & cone. Sae case iron for cows,
I 4 42 N 1
I 24 " - 1 I
I 1 A
/
/ r ' � �
Al / �.
/
.
1 1 1 I 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 , 1 1 �
1 1 1 1 1
H 1 i I I 1
! , 1 1 1 1 1 1 1 1 1
r / (a 1 1 1 1 1 1 1 1
1 I 1 I I 1 1 I I 4CNxRE s./.
I I I I I I 1 I 6 -6 10 -10 or
1 1 I I I I I 1 1 NBAV I1Rt MRS
I I I 1 I I 1 1 1 1 1 3'
1 1 1 1 1
1 1, 1 1 1 1 1 1 is .
1 1 1 1 1 1 1 I 1
1 y I I . 1 I I 1 I I
' , 60" 111 I
i :::: —1 It
iiii
IiI
' . t t' y Q ►F,` Ord 1 V '"
} w +I p
- onrtle a y 'lr.f"�.' " 1 1 I �i M' M�.
i �. „.; � „ ACT 2 6.1993 „ „I I
ii i'i , .....w _ , .. I I II i ,�y y ,
Y, ih T ti 1
l II t3AFiF1E4D COUNTY
, , y l I y p:
.', ii � HI h Country �l r1n0, Inc. ^I I I °�
Iw „ 923 Cooper Avnu ,
' nwood Springs I I
81601 ,
+ ” Gle
303445.8678 FAx 0 3.945.2555 �' . '1
I II
� �� p 1
VI II TO V . j A ^� � ( ' M4ril s 1 d ^ DATE ■ o1't -►( 1 3 ti' � ",Iu F
y
. a. II {1 + SUBJECT A F 4M c Is 0 ' HI I
mil " ^I
,,, 1N
nnnAAA .
�,. ' M.I. Pr , i l' JOB NO. '7 70 1 iii "
0 ATTN
1` J1
I A { „ FAX NO ,//''' Sheds 1. 4 •i..,.
„ + 6' We are sending the f� �
^ : Herewith Under separate cover I iI ,, w
' ❑ Phot000ples Prl,nts ❑ Documents# i 0 Mylars ❑ Shop Drawings p1,
II '
1 NO. OF I'�' LATEST REM `II
COPIES ITEM DATED 'REMARKS fi ^:
I I p
1 Z )4p4 -- p'�sLc ) l
ri
1191 'I l
III hi ir
hi
7
I
I• II
it „ -I
C.C.. U _SS ° '„;:
i9 I' 'V
If material received Is not listed above. kindly notify us;atonce. ,: -1
LI Transmitted by:
❑ First class mall
❑ U.P.S. Next Day 'Air ++
❑ B y I, , c � 1
F
❑ U.S. Express Mall T I Idi,
❑ U.P.S. , Std. Service k
b� r
o Pickup i f
❑FAX 1
ill I'l
If ❑ '
py � y „ 4
s
.,?a ^�u�� � ;. _ r va.,, Ili r ��, . � _. , u, ^ as IRS _ � iii } d