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Home My WebLink About02603 : "'I: ?`m , I • - ---� GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 U •' 3 109 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 GLENRIDOE CORPORAT Address 12694 Hwy 82, Carbondale phone 963 - 2561 Syit+t'location 12644 Highway 82, Carbondale Legal Description of Assessor's Parcel No. SYSTEM DESIGN / An' 1O2 nfrPt,v. , SS 47 on 6 Septic Tank Capacity (gallon) Other • 3 "^t �A Percolation Rate (minutes /inch) Number of Bedrooms (or oth Required Absorption Area - See Attached Dry welt 1 ;'X /2' i 2 1 d. , Special Setback Requirements: �_ �,,� /�_� Date 3 `f - /3 ` 9' ' Inspector f) + O'41 ( t—re- -4. FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering �� QQ Installation �y System Installer _ ""te' Septic Tank Capacity ��.•s� Septic Tank Manufacturer or Trade Name 02/4 471 - 4 V 41 d/ £ '. Septic Tank Access within 8" of surface)5 Absorption Area [rhi P /ix e2 » 2 Oiy i et i Absorption Ares T and /or Manufacturer or Trade Name /lam a-e , / Adequate compliance w r. w ith County and State regulations /requirements Other a 4 f i' Date $79 Inspector ,77t+1 -Pi 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 fr , . INDIVIDUAL. SEWAGE DISPOSAL SYS.T11LL1PP.I.ICATI91l ) �Q OWNER „ -_,- ASPEN GLENRIDGE CORPORATION ADDRESS 12694 Hwy 82 Carbondale Co pEIONE 970 963 - 2561 CONTRACTOR Osage* Exravation & Cons.trnrtign__.jGJen .T. tieehan) - ADDRESS Box 28491 U Jebel Co 81628 PHONE __970 9273431 , Mobile 970 923 6331 tone 1566 PERMIT REQUEST FOR ( ) NEW INSTALLATION ( ) ALTERATION (x ) 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 Zest holes, soil profiles in test holes (See page 4). LOCATION OF PROPOSED FAQjJ.ITY: COUNTY .. _. Near what City llr Town _rnYhnnrlate Rural acres.- - - -- -- Legal Description or Address - -,. 12644 Hwy 8.2 Carbondale Co 81529 _ WASTES TYPE: (x10 DWELLING __ -- ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE --- -_ - -. -._ -- —, - — IIUII.I)ING OR SERVICE TYPE: _ HOUSE —_ Number of Bedrooms Tr, rata - • .. Number of Persons . 2 tfaroage (hinder ( yes Automatic Washer yes Dishwasher SOURCE AND TYPE OF WATER SUPPI.Y; (xx } WELL .( ) SPRING ( ) STREAM OR CREEK Give depth of all wells within 180 feet of system: 160 - qn fr __— Ifsupplied by Community Water, give name of supplier - -- - -.. _.. _ (MOUNT) CONDLIMNS ;. — Depth to bedrock: — _ - -- _ - -- -- - _ - -- Depth to first (hound Water 'I'+rble —_ • _ . - -- . I'ercent Ground Slope .----- -- - - - -.— _.. --- „ -- � _ DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:--_ ?.m1�__ - Was an eRoti made to connect to community system? ( ) YES (14 NO I'YPE OF INDIVIDLIAI. SEWAGE DISPOSAL SYSTEM PROPOSED: (t) SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) PI'f PRIVY ( ) INCINERA'T'ION TOILET (' ) RECYCLING. OTHER USE ( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE_.__- ANAL DISPOSAL. BY: (QQ. ABSORPTION TRFNC11, BED OR PIT ( ) EVAPOTRANSPIRATION ( b4) UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE— NILI. EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF TI Ili STATE? 2 , LJ ?RCt`1,AT1ON TEST RESULT&; ('I'o be completed by Registered Professional Engineer) Minutes ' per inch in hole No. I 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 RPE who made soil absorption tests: - Nance, 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 he 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 teens and conditions as deemed necessary to insure compliance with rides 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. 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 1 1 G� . 1l _ /2-- Date J /d 4 l'I.E SA 'E DRAW AN ACCURATE MAP TO Ynl1R aR_OPFRTYII 1Z6i`I V1/4 10 ' tie pro ktzlc c apt t n_r o Y"'`l 3 Ntly m ';d L on 4 c p p, 'ft r 'pail � �� r � y NN �y l zy � 9' �u" I or 4 ' . ' 1 giro/9? d r d - w att iii[N 070 M : i ��l 010/)69 �wl�dh4i 1 o � � .