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Home My WebLink About02569 .,. i:•+ex• r„g Rrr;.,uyw.�..,.... ..:,.. m .. )eA; +w. , .^ ;rr« .. .. i 1 t -4 • • I . \ GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 56 9 109 8th Street Suite 303 Assessor's Parcel No. 1 Glenwood Springs, Colorado 81601 �. ,■, Phone (903) 945.8212 o`et, -44r- a.> : A\ This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a buildindor use permit. r •' \ 1 < "l\ ..�. \ PROPERTY n \ > ' + ' Owner's Name Ernst Schopp p resent A dress 0335 Ukele Lane Silt r Pho -2131 System Location 03/3r - ' `' ,, .County Road 229. Silt ' . k ., ;.S �'' Legal Description of Assessor's Parcel No. 7'07 4 RRe t- t LE4 @a 8 aye ula# 4 y, D S P e c.i1e T+ t 8si g R SYSTEM DESIGN $ OZ. - 7 - tir /.- 7 4' '7 a4 Sot 41 ens - O / G Fos arl.5 /64/l Septic Tank Capacity (gallon) Other /; JAI 14 ynaPercolation Rate (minutes /inch) Number of Bedrooms (or other) &a larei 4 E 7J /spd .eon Required Absorption Area - See Attached Special Setback Requirements: . Gate 4- /1 -94 Inspector /e4n 1 •-n*a•. o. FINAL SYSTEM INSPECTION AND APPROVAL (as installed) I Cell for Ins 9ction (24 hours notice) Befdr Covering Installation ; v al' `t J System Installer owmeg • ,. Septic Tank Capacity //1,0 41 Iciii n � Septic Tank Manufacturer or Trade Name thy Jett Septic Tank Access within 8" of surface YEs t Absorption Area 6 7�" r Absorption Area Type and /or Manufacturer or Trade Name Sa 7 - n1 F /t- rp,#Tde a97 a of Adequate compliance with County and State regulations/requirements Vitt Other � , _ Date - /7-9Z- ! Inspector o- J . n -i v - RETAIN WITH RECEIPT RECORDS AT CO 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 off ice 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 __ .. • • ?- 4 r INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION /- OWNER I>�NS� °f' HkR / /1 �L ROTE ADDRESS 0335 G17(.515 ,c 4-N45 PHONE ' 0 — - 6 ( CONTRACTOR gr. i mil_,. ADDRFSS ) h i'4 Ae.ee ss, R.a PHONE 5 �' PERMIT REQUEST FOR OK 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 profit in test holes (See page 4). LOCATION OF PROPOSED FACILI'►'Y• / COUNTY Near what City or Town Atli (n%xxll/e0 Size of ►.ot //, 6W ,ACRES Legal Description or Address 7 ff £2 coei f e oac / 9 J','LT r/'. _ WASTES TYPE: (4" DWELLING (J ( ) TRANSIENT USE ( ) COMMERCIAL Olt INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: m 1-6 JWEG! /tv La _ Nun rer of Bedrooms_ Number of Persons _�___ (4 Garbage Grinder ( Automatic Wisher (l�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_uame of supplier GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table Percent Ground Slope DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 1 Was an effort made to connect to community system? ( ) YES (VNO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 0) 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: (t,C) ABSORPTION TRENCII, BED OR PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) 011 IER- DESCRIBE.__ l i jrg»To/? /3L -S . STrn i will EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? /6 2 PIiR(kI)LA TEST RESULTS (To be completed by Registered Professional Engineer) Minutes per inch in hole No. 1 Minutes per inch in bole 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 fiunished by the applicant or by the local health department for purposes oldie evaluation of the application; and the issuance oldie 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 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 provider) by law. Signed • • • -, • - • 4: _ /�-/ 4' - Date PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 5i1 fir N1-1 02 teem r r cR a 1 19 Peo P 3 ee-7"0, //a // 00 -'* 't 4- g 4" os ,s a, -rte � { � 1 w - g 3 —r$ / 2 �{ .20 /bo `3 tiouskE CD c9 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 6 9 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 1 his does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a budding or use permit. _I PROPERTY Ernst Schopp 0335 Ulcele Lane, Silt 876-2131 Owner's Name__. _ ___`___ _ ____.___. Present Address _...._._ __ ____ _ __._ ___. Phone System Location 0 County Road 229, . Sil t Legal Description of Assessor's Parcel No. SYSTEM DESIGN 0 e''Cs Septic Tank Capacity (gallon) Other v / /..!` ._. y C?1� (� ercolation Rate (minutes /inch) Number of Bedrooms (or other) /____ On) /, 15/446, Di pc" S("AG. . e Required Absorption Area - See Attached Special Setback Requirements: Date 1� - - -- Inspectors ..[t�t�Qe _.....- 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 Slate 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 1, Petty Offense ($500.00 fine -- 6 months in fail or both). Wlt;te - APPLICAN1 yellow. 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