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Home My WebLink About02595 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 9 5 109 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 Barton Porter /Frank Col�ip� Address 2571 CR 314. N.C. Phone_ 984 -2790 System Location Lot 1. Sierra Bluffs. Silt S8 7 -) Legal Description of Assessor's Parcel No. SYSTEM DESIGN /Goo Septic Tank Capacity (gallon) Other /VC 6 401 - 41- `- G Qi v assp 3/ Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 / " /.v 3/ wrw 2a� L P 9GIy Required Absorption Area - See Attached /OS °� ' 8ry 63/ 0 &o Special Setback Requirements: -}'' GYl 603/ /,71 //✓Fi�/JP/9>tr' = 39 vim,/ /93 Date `5 - t - r6 Inspector V /4'KF 11 FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity /Q✓74 Septic Tank Manufacturer or Trade Name d ry.�4.n0 Septic Tank Access within 8" of surface y 6 -S Absorption Area /a � l L N fit 7 . 2r47/31 egs .2A t �sy7GS J` C �' 1 � - / 6 Absorption Area Type and /or Manufacturer or Trade Name .114/ / O Adequate compliance with County and State regulations/requirements t!!s Other Date T > / �y Inspector / 1-1 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 • II] DI YI DUALSE WAG E_DISPOSAL_SYSTENkLAPPI,ICATION OWNER SPer0 T. te. - Rr ttte (/), CO Lt. 1NS ADDRESS . b I. .i,,;.vi_ .9 PIIONE 98 790 CONTRACTOR ADDRESS PI - TONE PERMIT REQUEST FOR (,Q 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). //�� LOOATIONQ1'_PROPDSEI? FAOILIT_Y: COUNTY eft Q €L,D Near what City or Town SILT Lot 3 t sea P_5 1.egal Description WASTESIYP_E: (Dwelling ( ) Transient Use ( ) Commercial or Industrial ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Number of bedrooms: 3 Number of persons 3 ( ) Garbage Grinder V)Automatic Washer ( ) Dishwasher SOURCIiAND TYEE DFSATE t1PP_LY_: WELL () SPRING () STREAM OR CREEK Give depth of all wells within 180 feet of system: 449/1"I If supplied by communtty water, give name of supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: T Percent Ground Slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: no frfI Was an effort made to connect to community system? NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (1 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: O4) Absorption "french, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCI IARGED DIRECTLY INTO WATERS OF THE STATE? iS/70 fr- P13I?.COLATION_TESTIWSULTS: (To he completed by Registered Professional Engineer) j. 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 RPE responsible for design of the system: Applicant acknowledges that the completeness of the appliction 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 proposes 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 evluating the same fro 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 provided by law. Signed t,ai_ �, , Date ' / —; PLEAS I: DRAW_AN_I Cal IIATE_MAP_T2Y .11E_PROP_E RT_Y_ • ; . , -- • f • „ ••,:s 4i .:• ,,•,; •• .i.••• ., I f •: , r } `� L . 1 A �/ ( A LYSON R. JUNOJONANN e V ' C /0.80% 432 )p NEW CAS11E. CO. 61647) O mg CD .. / ` . ` 7/ . LOT 1 -1 I N1 k1 • I y3 ri 1 p2 9.994 NCt /- K2 1 A R aL- DC -sAC . - - so, 'ROAD warms r do (Emma uspexr) 7 . I-- • , • -'. 1 1 . '4 ,,, � C7•. i l y , ( DENNIS WAYNE M WANDA SUE 'L 11116 EOTA ROAD I so rt 0ORCSE>tossss a L 4 Ir. Dewar tacos EAST C6 LOT 1-2 § Cri ` UU 14.295 c +/- \. C 5 L __ C4 • PNCN i• It • , r 6281 ' J ? i � � ,, 3 0' ALTA JC$A OAD i C3 e1eI2) % /�� C2 R01D C ��4 C1 Ps' LOT 3 12.147 ACt /- . ie 1 • S 1 L1 6 72 700 2. 46 I ( J! It 5mOGET RIOCC i • X016 COUNTY RD. 331 SILL CO. 61662 ) v di/P02K5/yeer / TA /c e 6S n 5 . _s pP_oP //g 0 z � 8 G y yi/s D2" Cr) y 3 �8 vr,vio 7 /v Z3 ; 3 = 7. 7 Avl -i'A6E 7 30..i = 2to 3/ / 8 7 avn s 1 1 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 J J 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 Barton Porter /Fra Colkit Address 2571 CR 314, N.C. Phone - 984 - 2790 System Location Lot 1, Sierra Bluffs, Silt 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 SYSTEM INSPECTION AND APPROVAL (as i • Call for Inspection (24 hours notice) Before Coverin / � System Installer /�'AI Septic Tank Capacity - Septic Tank Manufacturer or Trade Name ®�� Septic Tank Access within 8" of surface _ �� - - - -- -- - - - - -- Absorption Area — t, Absorption Area Type and /or Manufacturer or Tun / -mss lice Iii - Adequate compliance with County and State regu 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' 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 requl- nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically' 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 kr. variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense months In )ail or both). White - APPLICANT Yellow • DEPARTMENT