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Home My WebLink About02571 .,._..._ _.._ .. ,,,. �.,.:._. ,,,.. - L. . O GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT --Permit 2571 109 8th Street Suite 303 t `"Assessor's Parcel No. Glenwood Springs, Colorado 81601. Phone (303) 945 -8212 This does pot constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT t a bullping or use permit. PROPERTY owner's Name Gilin Jonea Present Address 77 CR 306, Parachute Phone 285 -1360 t System Location 7256 County Road 306, Parachute Legal Description of Assessor's Parcel No. ` ` � '� 1 ' ' '' ' ` SYSTEM DESIGN O 0 Septic Tank Capacity (gallon) Other t n .,., '' '' s /N /S firPercolation Rete (minutes/inch) Number of B nerj ' 1' 1' Required Absorption Area - See Attachedater �,s -ems B co[ A/3q# ryr,Lr/ e1ra2 a3 Special Setback Requirements: . 4/99 t 4,a PisFs - 5 40 5 �s Date 3 aS �Y Inspector 'J��"" FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer f J G1AIE �P. Septic Tank Capacity. �a5 Septic Tank Manufacturer or Trade Name eP fiZond Septic Tank Access within 8" of surface yt�` Absorption Area h c../7 Absorption Area Type and /or Manufacturer or Trade Name &a , Z2F #LT ?r(T6L c9 8 , Adequate compliance with County and State regulations /requirements_ Other �• ^7��p / �-; /� 1 Date 3'�-9� 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 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 1, Petty Offense ($500.00 fine -6 months In jail or both). White - APPLICANT Yellow - DEPARTMENT l ir INDIVIDt1Al, SI WAGE DISPOSAL, SYS APPLICATION OWNER L.7/1/ 1 .1.) VO A) C S _ ADDRESS_20/ 0 R -3o ( PHON1 0_J2t5 in 0 CONTRACTOR__ �l1' end f C ADDRESS PHONE PERMIT REQUEST FOR (fi) 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 yes (See page 4). LOC TA ION or pitOPOSFD FACILITY; COUNTY Cr9. 17e /e Near what City or Town _p�ez?C2c t C_ _ Size of Lot --- Legal Description or Address -- WASTES TYPE: (vj DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE - BUILDING OR SERVICE TYPE:__ Number of Bedrooms . 3 - - Number of Persons_ ( ) Garbage Grinder ( t 'Automatic Washer ( ) Dishwasher SOIJ1tCE_AND TYPE OF WATER SUPPLY; ( ) WELL (Z- SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system:_ -_ If supplied by Community Water, give name of supplier_— -- - -- GROUND O DITIIONS; Depth to bedrock:_ -_ -_ ? _ -- -- Depth to first Ground Water Table L - Percent Ground Slope Pi o - DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: /f /A. S Was an effort made to connect to community system? ( ) YES (L)' NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ()4' 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 IIY: (ABSORPTION TRENCH, 13ED OR P11' ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL, ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWA'T'ER POND ( ) O'1'IIER- DESCRIBE_ WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE S'T'ATE? Na 2 PERCOLATION TEST It SUI:j; (To be completed by Registered Professional Engineer) • Minutes per inch in bole No. 1 Minutes per inch in bole No. 3 Minutes per inch in hole No. 2 Minutes per inch in hole No. Nance, address and telephone of RPI: who made soil absorption tests: Name, address and telephone of RPI: responsible for design of the system: Applicant acknowledges that the completeness of the application is conditional upon such fiirther mandatory and additional tests and reports as may be required by the local health department to be made and f iniished 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 terns 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 niy 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 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 =— Date 1'1.1ASE A _ DRAW N CCU IRA'1'I MAP TO YOUR PROPER'T'Y! 3 7- g :)S /// ) '11:— K / / S I Q 7 `44 = I g - s`o 4 3 r /� rar I {v ,z5`b u = /s 7 3 p Rini -t l� --xwi )Sb.d X39* <L4VF7g.r1 flZI 0 7$ o a o ,3 Tp i hbOgal