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Home My WebLink About02506 7ytr@rayg,Tn9'rAi rim t ` 1 '11;e11 • ,: -,K,kr 5 .1- rr;: y //r/t'3 y GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2506 / 70 , 1 , 4 4PC Assessor's Parcel No. /�� / 109 8th Street Suite 303 /2 6 Glenwood Springs, Colorado 81601 Phone (903) 940-8219 _ � This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a. building or use permit. jZ, - PROPERTY Don Trlach, et at. Present Address -7225 CR New Csls`'tle- Pki ' Owner's Name System Location 7225 County Road 314 Newtast:le lAtf� • S ` Legal Description of Assessor's Parcel No. -� �� 4 Rood! f Eb Woo !t% 444royc.D 9A,Go - SS�o>t SYSTEM DESIGN ?rr {"-) 4717aC r4 34g6 I'd to- D,FF be. te et. - 1- ysaSf ODl Septic Tank Capacity (gallon) Other / NJ I q,Mrlfiercolation Rate (minutes/Inch) Number of Bedrooms (or other) 3 Required Absorption Area - See Attached Special Setback Requirements: Date /h –/7 -Pilo Inspector c- . � r FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer .�G/i'M(/s°.Se,f' 1 Septic Tank Capacity /CVO �,/ Septic Tank Manufacturer or Trade Name w i e /i/ Septic Tank Access within 8" of surface )/ P3 u' / P /.S&2S • Absorption Area J` "Si 74l aa-S //✓F /n7ie/9 �,Ceu- J Z. ,f-2 'i /3 Absorption Area Type and /or Manufacturer or Trade Name /��/ Adequate compliance with County and State regulations/requirements VCIS Other Cite / e CPPe/Z- Date /o/,�'/9S Inspector ,7 ,Ke 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). White - APPLICANT Yellow - DEPARTMENT r `v, INDIVIDUAL_ SEWAGE DISPOSAL SYSTEM APPLICATION OWNER Don Trisch, et al. ADDRESS 7225 County Rd. 312 PI -IONE CONTRACTOR Schmueser & Associates, Tnc_ ADDRESS 1901 Rai lroad Avenue, Ri fl e, • • • ___ __ 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 4). LOCATION OF PROPOSED FACILITY• COUNTY Garfield Near what City or Town New Castle Size of Lot 280 Acres Legal Description or Address 7225 County Road 312 WASTES TYPE: (X) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Modular Number of Bedrooms 3 Number of Persons 2 (X ) Garbage Grinder (X ) Automatic Washer (x) Dishwasher SOURCE AND TYPI= OF WATER SUPPLY (x ) WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: 120 ' (Existin_a We1 1 ) If supplied by Community Water, give name of supplier GROUND CONDITIONS: Depth to bedrock: Unknown, Depth to first Ground Water Table 1 2 Percent Ground Slope <4% DISTAP : SYSTEM: 12 Mi les 0 Was an i ( ) YES (X) NO TYPE ( STEM PROPOSED: ( DN PLANT ( ) VAULT ;TING TOILET ( ) RECYCLING, POTABLE USE I A l,r, c ; tAT1ON TOILET ( ) RECYCLING, OTHER USE - DESCRIBE FINAL T ( ) EVAPOTRANSPIRATION ( ) SAND FILTER 4171C! ( ) WASTEWATER POND WILL lw crN I nr, i t,.Irt•� ... .._! INTO WATERS OF THE STATE? No 2 INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER Don Trisch, et al. ADDRESS 7225 County Rd. 312 PI -ZONE CONTRACTOR Schmueser & Associates, Tnc- ADDRESS • • ... - . - - P • ► , • . 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 Garfield Near what City or Town. New Castle Size of Lot 2R0 Acres Legal Description or Address 7225 County Road 312 WASTES TYPE: (X) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTI -IER - DESCRIBE BUILDING OR SERVICE TYPE: Modular Number of Bedrooms 3 Number of Persons 2 (X ) Garbage Grinder (X ) Automatic Washer (x) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (X ) WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: 120' (Rxistirt_a Wel 1I If supplied by Community Water, give name of supplier GROUND CONDITIONS: Depth to bedrock:, Unknown Depth to first Ground Water Table 12 ' Percent Ground Slope. <4% DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:, 12 Mi les Was an effort made to connect to community system? ( ) YES (x ) NO 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 ( ) OTIIER- DESCRIBE FINAL DISPOSAL BY: (X ) ABSORPTION TRENCI 1, BED OR PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) AI3OVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? No 2 w PERCOLATION TEST REM .TS: (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 teens 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 de of health in evaluating the same for proposes 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 / /tt.— :.,--- Date l �� PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 7i'nc /33C - ioroe_, 3-oin.N 11 g l�os3= *e) a r - ,i Z - 3 / FI J� `--7-1° k v?V01 6 y T z4 9' // —' z 3 _2 - 0 L1/4- -671' > ____-- - a6 ci 2 o, 0 �ra _7 X' =/ �ssR rto • a-dc‘ a °, G /rp � � m �� 3 j b 7 g_ c, 7 y r o c z a% r