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Home My WebLink About02577 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 25 17 109 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 Aspen Sports Inc. Present Address 7025 Highway 82, Glenwoodphone 945 -2892 System Location 7025 Highway 82, Glenwood Springs Legal Description of Assessor's Parcel No. SYSTEM DESIGN 7 5'0 Septic Tank Capacity (gallon) Other 5 persons Percolation Rate (minutes/inch) Number l edrooms (or other) .,e (/ �j /" /N 0 20 /M'N. 4 b O ( l 4.O'r P^�.., V 1-- C1 -c %�1 /-J Required Absorption Area - See Attached ! / l int L % 'T- 1� /v.� L r Special Setback Requirements: / 9 /3 -t..c C k` ° 'y Date Mal° G Inspector 1 test ! 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 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 viol 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 — months in Jail or both). White - APPLICANT Yellow - DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER_ /lsPE .5 /Nc ADDRESS7Qas llW'Y $2 $LOC PIIONE 9 70 -9Y5 as ? a? CONTRAC'T'OR ADDRESS PIIONI PERMIT REQUEST FOR ( ) NEW INSTALLATION (%J 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 FACILI'T'Y: COUNTY (.:lbei Near what City or'1'own_ GA rioacOb Sit/WC-5 Size of Lot -- Legal Description or Address 702,E wy fra no 9 WASTES TYPE: ( ) DWELLING ( ) TRANSIENT USE pQ COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING Olt SERVICE TYPE: L1f1 '(Se: Number of Bedrooms p —_ Number of Persons ,S _ ( ) Garbage (hinder ( ) Automatic Washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY' (X) WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: If supplied by Community Water, give name of supplier �� ` (S � Os>s), — GROUND CONDITIONS: reael9' JDe Depth to bedrock: — C1-`" zo — Depth to first Cirouud Water Table o - �xffl SYs'r — Percent Cirouud Slope /CAS e tW ey g � DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:_ p -T, 67 n �it c �- Ore _— � Glo o6e c , Was an effort made to connect to community system? fe�e. TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROP T / , r ti w ,Q,> (� SEPTIC 'T'ANK ( ) AERATION PLANT nnTf1m-G i1� �l�sauT. ( ) VAULT PRIVY ( ) COMPOSTING TOIIJ ( ) PIT PRIVY ( ) INCINERATION TOF ( ) CHEMICAL TOILET ( ) OTfI1 R - DESCRIBE, FINAL DISPOSAL BY: (t/CAIISORPTION TRENCH, BED Olt PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? N 2 r . INDIVIDUAL SEWAGE DISPOSAL SY.S'FEM APPLICATION OWNER A7IE•✓ 5 /'d/TS //VC- ADDRESS 7OaS Vr 5,2 gttte *el PIIONE 9 - 9 Y6 "a28 �? CONTRACTOR___ ADDRESS _ PHONE PERMIT REQUEST FOR ( ) NEW INSTALLATION 0,0 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_aff'e&t> —_ Near what City or Town G t r Aim ld h SPAM/CS Size of Lot Legal Description or Address 7025 f y' $02 $C.F)E — WAS'T'ES TYPE: ( ) DWELLING ( ) TRANSIENT USE pQ COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER- DESCRIBE BUILDING OR SERVICE TYPE: 6✓/gge N't 5C Number of Bedrooms _ 0 Number of Persons J- ( ) Garbage (hinder ( ) Automatic Washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY; (X) WELL ( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: If supplied by Community Water, give name of supplier (,ROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table _ Percent Ground Slope DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: I Mat- - Was an effort made to connect to community system? ( ) YES (r NO TYPE OF INDIVIDUAI. SEWAGE DISPOSAL SYSTEM PROPOSED: (( SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CI IEMICAI. TOILET ( ) O'I'IHER - DESCRIBE FINAL DISPOSAL BY: (ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION ( ) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE ^/ WILL EFFLUENT 13E DISCIIARGED DIRECTLY INTO WATERS OF THE STATE? /'r ° 2 plB('oI.A'I'ION• TE 'f RESULTS: (To be 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. Nauie, address and telephone of RPE who made soil absorption tests: Nacre, 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 finished 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 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 perjury as provided by law. Signed_ ( te t *i2_�1L Date a J /79 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 •