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Home My WebLink About02570 c\ • GA FIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2570 109 Bth 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' Savage, Joa Present Address 5953 320 Road Rifle Phone_ 625 -1675 System Location 4(66 County Road 320, Red Apple Orchard Sub., Lot 18, Rifle Legal Description of Assessor's Parcel No SYSTEM DESIGN /. /000 Septic Tank Capacity (gallon) /m o'�' Other 8a0 Ao 420y = /O39 4 .21 Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 / ll /N a/ /&.,✓ LsAUr Required Absorption Area - See Attached /0,37 Rou Bea e 33 t/Ni7.S /NF/L>xATVR S 23/o OIF.cus Special Setback Requirements: /N 4 BOO as qd • Date Inspector - FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 .hours notice) Before Covering Installatiop System Installer DAN 4f4.dO Septic Tank Capacity J001:2 evt4 Co'd!A crt Septic Tank Manufacturer or Trade Name COn•-• 1/v0 Septic Tank Access within 8" at surface PR" Absorption Area 3 3 - _. + Absorption Area Type and /or Manufacturer or Trade Name . // Y F/1(144 16 Adequate compliance with County and State regulations /requirements S • Other Date g. _ — Inspe. or RETAIN WIT - ECE •T R CORDS AT CONSTRUCTION SITE *CONDITIONS: 1. All installation must comply with all requir- ants • the lorado 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 st cturec whic have fully complied with County zoning and building requirements. Con- nection to or use with any dwelling or struct es not - • pro d by the Building and Zoning office shall automatically be a violation or a requirement of the permit and cause for bo legal : ctio and revocation of the permit. 3. Any person who construct, 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 Clash I, Petty Offense ($500.00 fine —6 months in )ail or both). White - APPLICANT Yellow - DEPARTMENT • INDIVIDUAL. SEWAGE DISPOSAL SYSTEM APPLICATION OWNER /�� Sid,-- ADDRESS f f rj - 720 //y' PHONE ' r /i7 5 CONTRACTOR 4 ADDRESS 76 4& — 7 r /f" PHONE 42 r'a 7�" PERMIT' REQUEST FOR (p- 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 S' PROPOSED FACILITY p _ _ COUNTY �/1!1 fltO G Near what City or Town ®I J rL h Size of Lot • 44-4# Legal Description or Address //f0 //17• 1,77 f trAre -Ff /o r /6' WAS'T'ES TYPE: ( DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDIJSTRIAI, ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE:_ / ��OF/�7 -- Numb r of Bedrooms__ 3 Number of Persons_ (''Garbage Grinder ( Ir Washer ( 11 SOURCE AND TYPE OF WATER SUPPLY: ( WELL ( ) SPRING ( ) STREAM OR CREEK (live depth of all wells within 180 feet of system: If supplied by Community Water, give name of supplier_ GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table Percent Ground Slope / DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: - Al .tt.S Was an eflbrt made to connect to community system? ( ) YES (vr NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( L -EPTIC TANK ( ) AERATION PLAN"f ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PTT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE FINAL. DISI SAL. BY: ( PIABSORPTION 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? / 2 PERCOI :AI'ION T ; " f t1SUI: f (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 ItPE 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 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 proposes of issuing the permit applied for herein. I further understand that any lilsification 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 i��r/ Date V5 /Y /4'F ' PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! ■ 7 ,vC5 r r c ,$. ,.. 0 tra 3 .2 v Rp / ,cc---- N Gen , !a 3 L — cook 535.5. Pa9s 531' .` l• >E. 38 D ....... N.8&251 8 1 f� 1 i IV 1 ' 1 1 I 1 I 9 1N ` t2 4 'N '`r' A 4c i . I � 1 I N. t 1? It Ij; I Q of0 9 • ( 1Z I z _ I �t 1 I LE I Iii ��J 4 36 6630.09 • N.81 . 1t � '-• -- J L 0'E. 667.48 N.88 E 667 4 N.8$ n vg a h -. 0 o \ c Si., 2 2 ■ I ,b s. ali r ao Y... J Ci a - re) l 8 th s 4' ? / 1• 9 ,.. ) 0 9 A s C . Water Well 1- OV E SAVAGE / — / 2 -0BO RCAS r ,,,1 1 , COLORADO 61650 a / - ' ' �,1e �"� ......... r .. / / / '09'36 653.85 ( " / / _._li - _1 / r 10 � 1 _ _-/ / / -- -14 `1 - / /J/ - 1 9, 1 9' . . // �>,/ i .1 P tiry). 2.262 Ac. ; , y z J 1 30 {I. Accost Eoseora „ci � . N.87 °4023•E. 357.23 _ W i r • F e nn _c • r N.88•29 - -- I - - { g^3 s • N .et 7 372.91 r _ -..11,00:291541F.,_ _CL �/ Rancho Tres 1 /et, iy / \ Woter WA ROY E. SAVAGE / N.35 •27'00•E. 7062 -309 ROAD 100.79 RIFLE, COLORADO 61650 1 / � /N, /(V • / o/4, ,, 9.5( % , / gigs \, . 8.392 Ac. N 1 20 A VI.15•59 1 Y /III 91.82 / go I / 4 b/ 1 1.88 09 / 1 34.54 / / i - -L N.02•14.3511. 189.05 1 189.05 J L ° - _ N.88 O• • 1423.32 / r � __ N.88 °09'36'E. 63726 _ __ _ \ - -. - r 104.63 _ / • 1 f --- -_ -... 104.60 0 1 I 33'21'E. / / I I / / • I I 0 cos Well I M / //4/fl I ti rePO 14.6 I ,0 I o 0 / � L r . I I ;I o . . � / / I r4.1 - v Pole Y. I NI 2 9 i o 2 8 x 1 0l W 0. (� .z 1 z1 « z 9.490 Ac. . R.O.W. :50.00 4 335, Ac . 1 I 1 Mal \°maucul femur 1 I 0 i / I/4 dornor of Saclion 1 I 34 •\ \\{ I � 0 It. Ac ces+Eoseaent Book535__ _ 137 M _ L t ...- --- \ J N.88 °00'07 E. 63_5.32 N.88 00 19 (_' N.88 °00'07 E. 635.20 x , \, Iv Wire Fence --- _` ..... , I Z :„Ji• 1 269 Ac . MI e' I0 Rook 535. Pog. 5 _ J . ` _ I I 4- � \ J L. 6E, -- §43 A I J 7 N.88'26'10'E. 667.48 \ N.88' i N.88'26'10 667.42 N - N.8�' 1 I -f -1 r 1 11 1 1 1 1 1 1 1 1 119 I I I 1�1 N 4 A•c . 10 1. ; 1 k t� I 9 I. I p M IN1� 9 . 1 N' 0 9.909 Ac . z l o l � . 1 I 1 Water Well 1 I 9 I I I II• ..- -h` I I II ..- __ _ 36 f630A9 _ - J I I I J � , N.88'0736 - E. 653.85 - 11.8 y - 1 �-- ' I d IT r 14 Ac . v1�i ,,;;;,, -9 .598 Ac . , . 9 1'I.- , \ ' I ail -' ' ' " / / ' M 3 I M \ A h 2 I 20.00 F 1 i. 20 foot Rood 6. Utility Eos.m.nt e Cor. 1 . 63 -1, L — t J L I N.88 00'07 640.32 - - _ - -- N.88•00/0: 1 . 1 1 10 f t. Holt r.- . 690,20 _ 1 R.O.W. GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2570 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 Savage, Joan Present Address 5953 320 Road, Rifle Phone 625 -1675 SystemLocation_gad County Road 320, Red Apple Orchard Sub., Lot 18, Rifle 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: Date Inspector FINAL SYS1 E ;a t,, F ECTfON ANC AP. JAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity 1 1 ' Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area 9 Absorption Area Type and /or Manufacturer or Trade Name Adequate compliance with County and State regulations /requirements - I 1 t `.\ Y Other C I n ` - 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 l eec /r..57 3 - 8 - 7 6 AND T i /1 ® 9 %g g 7% 1 2_ i / 1 04 aeo, !u /nrG-/cex - 6e, , v461 r4 —tc 6:{71-44/./) %free'° /2 v2 //, 4"rn 3z s � � O 2 8 X 2:0 3 13 7. 1) = 666 rfi /way 866 = X039 j (e '4 r O� 86� = 33 //, /r�4 ».4-mo /1/ 4.0 10361: