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Home My WebLink About02597 0 r ��V',.. I l: GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 5 n 7 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone / 1303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Barton F. Porter 2571 CR 314, N.C. 984 -2790 Owner's Name / Present Address Phone_ System Location a) /s ) /IA ntA Lo Sierra Bluffs, ( — taae4., Silt Legal Description of Assessor's Parcel No. 8YS4 /Qouc Lernui p ; P � SYSTEM DESIGN /A X 77 No G,i-ea4 f tae f4P - - /4 Septic Tank Capacity (gallon) Othe 3 PIPS 3 / 11 IN tokw4C nveine5 •— 3R0 Aiwne fl r 3 r, /d ' x 971 Percolation Rate (minutes/inch) Number of Bedrooms (pr other) /arcs P ao 'ass' oK ■ Required Absorption Area • See Attached , - p2�a.�.az -- - -„tY3� .- Special Setback Requirements: Date • S'� - 8 '/3 Inspector N.t ce FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspectionl24 hours notice) Before Covering Installation System Installer Q /4NLQ Septic Tank Capacity /d>12 Septic Tank Manufacturer or Trade Name ehyLyria2. P, S eptic Tank Access within 8" of surface 96s - Y o Absorption Area 1 !J Absorption Area Type and /or Manufacturer or Trade Name r, leaf ; / Fd`a Sze/ 3 fit.- 4/-0 X its ' Icr as Adequate compliance with County and State regulations/requirements UPS' Other .b (t Date P "0 • 4 .04 Inspector RETAIN WITH RECEIPT RECORDS AT CONST UCTION 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 shalitutomatically 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). - 0 White • APPLICANT Yellow - DEPARTMENT • • Tile - � 7»/LT /O /00 ® s 8 e y e 1 ��L'Jr�ii� %s [Clef+° v/g %s 0 6 so r 3 3.33 ' 3 3 ----- yfa 7.2. �//�r r- . X a ✓o Tar 7 31 star / /Ls An EEno 0 R1 /m44 m ils 7 3 0 8 3�veao s =3 = I.a /•67 3 )rv . ODRd° ION V ��n s' _ I tl Q ' ✓AoDnno" r[ • gpic N„ este° 4 • 41. - y GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 25 9 1 109 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 F. Porter Present Address 2571 CR 314, N.C. phone 984 -2790 System Location Lot 2, Sierra Bluffs, (Serenity Lane), Silt Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) —Other 3 Percolation Rate (minutes /inch) Number of Bedrooms (or other) Required Absorption Area • See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL g insts Call all Inspection Inspection (24 hours notice) Before re Covering ng Ir System Installer_ Pa 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' )/�I� Adequate compliance with County and State /�� 7 1. 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 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 jail or both). White - APPLICANT Yellow - DEPARTMENT • • • INDIYIDUA A DISPQSALSYSTENLA (BREion r /tierce F'enN,e GU Etas OWNER ADDRESS • aubu y :4ty Akeorkal PHONE 919' -2290 CONTRACTOR ADDRESS PI PERMIT REQUEST FOR (% 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). LOOATION.00PROPOSED CACILIT_Y: COUNTY Q Lett' FI w,Lef Near what City or Town SILT Lot fi k SLenen IRLuFF /y,euf I.egal Description SEtN / T+' C4N WASTESIYPE: )welling ( ) Transient Use ( ) Commercial or Industrial ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: 3 Number of persons 3 r thethi4111 5( ge Grinde KAtitomatic Washer ( ) Dishwasher SOUROILAND TYn_r OF_WATf:Il'_.SUPPL_Y: 60 WELL () SPRING () STREAM OR CREEK Give depth of all wells within 1811 feet of system: NCOA/A If supplied by comnumtiy water, give name of supplier: GROUNI2CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent Ground Slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Two ML /es Was an effort made to connect to community system? NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 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: (0 Absorption 'Trench, Bed or Pit ( ) Evapotranspiration (`) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: WILL EFFLUENT BE DISCI IARGED DIRECfLY INTO WATERS OF THE STATE? NO ' _4 . j P1RCOLAT14N_TEST_RESL.: (To he completed by Registered Professional Engineer) i 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. _ 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 purposes 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 be 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 Set-, 6:7-2/ Q/ Date //' / t PLEASE DRA.YY_AN_ICCURATE_MACT2YnUIUN WPLRTY • y W A to 2 7 0 P a ______\ o j 1 � o , ff IL 2 I:, 1 voio _..„ . N� \ t 1 Cou f.NTy RD .s3 • • • 4 S Ti1r_ r // ; /KAA - J t li 11 : /! - 7 11 ,6 i/6, /9 /vr /07 3 2 3 3 -/ 767 a� >/60 267 = 020, T ' X r