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Home My WebLink About02509 1 ri 9 .� • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2, 109 8th Street Suite 36;70 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 Owner's Name Stephen Halllsay Present Address P.O. Box 7145, Aspen CO Phone 923 -3265 System Location County Road 112, Carbondale /G // 'Legal Description of Assessor's Parcel No. SYSTEM DESIGN DESIGN +• /OC( am/ Septic Tank Capacity (gallon Gegif .`'S/.1. Cher Percolation Rate (minutes/inch) Number of Bedrooms (or other) 3 7 /e4 tax Le.fu,' Be.O Required Absorption Area - See Attached p� -- CA3PN/fl NF�c -voe o/a 840 Ditora r,e-' yo�90 Special Setback Requirements: Date 3= / 3 -94 Inspector Araft ° ANAL SYSTEM INSPEC AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation / / �` System Installer to .4 )8C Septic Tank Capacity /.`S"n Septic Tank Manufacturer or Trade Name Gayer Septic Tank Access within 8" of surface 9,-s 4 Absorption Area 9.-CL Absorption Area Type and /or Manufacturer or Trade Name 1 N F /4>/ y 7/2 Cs 3 ( & A Adequate compliance with County and State regulations/requirements _VFs Other Date 6-1 `96 Inspector PI-lieu 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 I N P_I Y_I IllUALS nW AG E _DI S POSAL_SYSTEM_AP_PLICATION OWNER . r 'h ■• •P c, - ADDRESS FV ICI K ii. • . • / PIIONE qa 3 - 3? 6 C CONTRACI'Ott ow EA_ ADDRESS _ 5a-rn PHONE PlfltMI'I' II EQUEST FOR (k) 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). n LOCATION_OF PItOPOSIiI? 1 ?ACILILY: COUNTY tra rtield Near what City or Town . car/Xi-Ida it Lot (,) rdurl1J /2r] / 1) . L Legal Description C _2-`- 77.75, _egg ( E _Q. E �4) WASTES_LYPE: (0 Dwelling ( ) Transient Use ( ) Commercial or Industrial ( ) Non- domestie Wastes ( ) Other - Describe RUILDINGOR SERVICE TYPE: PGtrn;1 ale 11; Number of bedrooms: _ 3 Number of persons a (A-) Garbage Grinder (r) Automatic Washer ('t) Dishwasher SOURCLANP__T WA'1 (k WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within IRO feet of sys(em: -- If supplied by comnnunliy water, give name of supplier: — GROUND_CONDTTIONS: Sand f (riuvt I Depth to bedrock: 'et' Depth to first Ground Water Table: /20 F - - -. Percent Ground Slope: _ DISTANCE TO NEAREST COMMUNI'T'Y SEWIUt SYSTEM: Was an effort made to connect to comm system? TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (e) 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: (C) Absorption 'french, Red or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Fillet ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: W11_I. EFFLUENT BE DISCI !ARCED DIRECTLY INTO WATERS OF THE STATE? 4!0 L'IU CQLA1iON1'ES'LRESUL"1'S: (To he completed by Registered Professional Engineer) Minutes per inch in hole No. I 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 RP F. who made soil absorption tests: Name, address and telephone of RP1 responsible For design of the system: • Applicant acknowledges that the completeness of the appliclion is conditional upon such further mandatory and additional tests and reports as may he 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 inusre compliance with rules and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies That all statements make, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to he True and correct to the best of my knowledge and belief and are designed to bre relied on by the local department of health in evlua1ing the same fro purposes of issuing the permit applied for herein. 1 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 pe rjury as provided by law. Signed _ / `t/at r Date /0//7 / • PLEASE.DRAW AN_ACCLIRA E.MAP_T_O YOUR_PROPERTY„ I rua><h ook• CUM C r1b -C t Ule 103 Low oaq Couwv \a II enra��.t KJ J Pit ■ W �3 ____ All.----------g----mranialanomaws-- - - - -- --- WO QC OtiA CA. ProP ° sea G x p1- '�vewiAY � d a6 e..L ri v P E i . P� , - 5e1 - i �, F �� t1Pw� C m - - - - - - 0; Nei.914x0rs wen S\ YE PLAN ' Scu.le %„ r. 100 r- GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 0 9 109 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 Stephen Hallisey present Address F.O. Box 7145, Aspen CO 923 -3265 Phone System Location County Road 112, Carbondale Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 Required Absorption Area - See Attached Special Setback Requirements: t 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 /- 7 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 )ail or both). White - APPLICANT Yellow - DEPARTMENT ® jp" 3 72 30 nr� Tes� thieixter i ,, s i3 % /a<y Vec Ja s Ate, 6 b _ 4vsai+be 30 t/ 7 94 +3 = AY/ei4s /1145- 30 — *15.1--. t- /0 "7/9.n g / 1P- = ` X acV 7/8 O Pot' G',4 417z_ MAWS ae B y� a_3 (1/20/1-3-