HomeMy WebLinkAbout02605 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2605
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 Porter & Lori Cooly (Joh preatzu ss 0656 CR 308, Parachute Phone 285 -7180
System Location • 0656 County Road 308, Parachute
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 THERE IS AN EXISTING
_» .. SYSTEM INSTALLED UNDER PERMIT 01015. THIS PERMIT IS
Required Absorption Area - See Attached FOR EXPANDING THE LEACH FIELD TO ACCOMODATE AN EXTRA
BEDROOM ONLY.
Special Setback Requirements:
Tic Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer W •1 P r 1
Septic Tank Capacity 1/ 0 0 0
Septic Tank Manufacturer or Trade Name `-o f" tt
Septic Tank Access within 8" of surface 1/
Absorption Area AJci. INhI?*rill t0 1Z To / Mo Bed Roo "7'j
Absorption Area Type and /or Manufacturer or Trade Name � fl y ? # k 4 r 0 n
Adequate compliance with County and State regulations /requirements
Other /. p cry
Dates? — .2 j — ! 6 Inspector N. 7 "fi
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 Yel NT
` INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER P. r, y V}\ LJ Pbe-
ADDRESS 7!)I,!- ("pi / kr( ¶40 PHONETIC) — 69 - 5 as,
CONTRACTOR 4 kn: 2 C' p r! ).
ADDRESS PHONE
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).
LOCATION OF PROPOSED FACILITY• COUNTY G14e F I t= (')Th
Near what City or Town Size of Lot t /DD O SC / SOo
•
Legal Description or Address ��� .n !Laos. IA/14W n_a/�- - l
r
WASTES TYPE: ( ) DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE "TYPE: 074-n -« .
Number of Bedrooms 3 Numb r of Persons
( /Garbage Grinder ( PKAtitomatic Washer (shwasher
SOURCE AND TYPE OF WATER SUPPLY; QO WELL ( ) SPRING ( ) STREAM OR CREEK
Give depth of all wells within 180 feet of system:
If supplied by Community Water, give name of supplier
GROUND CONDITIONS:
Depth to bedrock: 1 1
Depth to first Ground Water Table / i
Percent (mound Slope
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to community system? ( ) YES ( ) 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. DISP AL BY:
( VAI3SORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION
( ) UNDERGROUND DISPERSAL ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL. ( ) WASTEWATEIs,,,1'OND „ �J
( ) OTHER-DESCRIBE 79e • ! _ -�' 41 Va' r(('on4' /dt t
WILL EFFLUENT BE DISCHARGED DIRECTLY INTI WAT'�S 0" HE STATE?
2
j'fjkCQ1•]TION TEST RESIII:I'S• (To be completed by Registered Professional Engineer)
• Minutes per inch in bole 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 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 fitrnished 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. 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 `j / --y
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
• GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue •
Glenwood Springs, Colorado 81601
Phone (303) 945.8241
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 10 e building or use permit.
Owner John I< Joan Savage 0 S/o C R36 Ss
System Location Section 17 - County Road 308 - Parachute -- } y �,�,� -!, ` \r • „
Licensed Installer
• )'Yw
Conditional Construction Pn ^ ' • ` - ° - ' ” _ ar-en'j
N Septic Tank or . 1.1 r
3 ftaTle. Absorption area (or dispersal
Perc rate of one inch in '' \ ' � t. of absorption area per bedroom.
Therefore the no. of bedroon ' a total of aZiasq. ft. of absorption area.
May we suggest left •'•
Date
FINAL APPROVAL OF SYST
No system shall be deemed ti it the assembled system is approved prior to cover-
ing any part.
60/C: Septic Tan _ nd surface or aerated access ports above ground
surface.
c,� Proper materials and assembly.
Trade name of septic tank or aerated treatment unit.
(. Adequate absorption (or dispersal) area.
e"./C
Adequate compliance with permit requirements.
_�—/— Adequate compliance with County and State regulations /requirements.
,— Other r7//
Date /P/�',71 `/ Inspector __E29 / 9
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 66.44.4, CRS 1963, amended 66 -3 -14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements.
Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viola-
tion of a requirement of the permit and cause for both legal action and revocation of the permit.
3. Section III, 3.24 requires any person who constructs, alters, or installs an individual ( sewage disposal system in a manner which in-
volves 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).
Applicant: Green Copy Department: Pink Copy
(TO BE RETURNED TO RING_ R SANT nrpT 1
• GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945-8241
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 1015 r a building or use permit.
Owner John Pt Joan Savage 0 4 5'/0 C /?3 —
System Location Section 17 - County Road 308 - Parachute - ) n,,`i,);_a. ` i •,r -.,
Licensed Installer
• Conditional Construction approval is hereby granted for a 75 gallon
)( Septic Tank or Aerated treatment unit. y
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in a' minutes requires a minimum of /. S. 5� sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms 4=2 x asq. ft. minimum requirement = a total of "o /t sq. ft. of absorption area.
May we suggest ,/ A'aiJ /° sv.UF" ; / ...<'a
Date ...1. / Inspector /f :f. -r., .., ,:,. �.:: •..._.
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover-
ing any part.
et Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
t, Proper materials and assembly.
,�f�1 � Trade name of septic tank or aerated treatment unit.
�rr�
O ( Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Other �/ �j�.
Date //07/O ( Inspector __t j� 1 - " " -_ 2
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au.
thority granted in 66-44-4, CRS 1963, amended 66 -3 -14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements.
Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viola-
tion of a requirement of the permit and cause for both legal action and revocation of the permit.
3. Section III, 3.24 requires any person who constructs, alters, or installs an individual ewage disposal system in a manner which in-
volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class 1,
Petty Offense (5500.00 fine — 6 months in jail or both).
Applicant: Green Copy Department: Pink Copy '
(TO BE RETURNED TO RI DG R SANT nrPT
1
JILDING PERMIT APPLICATION
•
:FIELD COUNTY BUILDING AND SANITATION DEPARTMENT
Garfield County, Colorado, G, ,�
19—
4, ti Ai Sa0Q'
ra
.tractor or Builder: e\hi �"' f
- :tion: _ Ser- f 7 ; d it 21.
I, pose for which building is to be used: it �l ;0 / lie
of Lot:. 3 0 h c >f'
ranee of building from property line at d ! o CJ !
Mt: To Rcar: (�a
4 I Lcft Side: Right Side:
tancc from nearest building: fro 0 r Number of stories:
` urcc of water supply: �� if Number of rooms:
�� p
pc of sewage disposal: ,S a Type of foundation: C✓�
dth of building: Material in outside walls:
ngth of building: Exterior finish:
-ivht of walls: Type of roof:
o
oor space in square feet:
imatcd value: $ , — '7 u y �
-te construction will begin:
Date of completion: �
Permit charge: $
Plan check fee: $ _
TOTAL: $
And I /We hereby agree to build strictly to the terms of the above description, and also to clear the grounds and
tjacent street or streets of all rubbish and debris causcd by the construction of said.building.
Respectfully,
Are County Commissioners hereby grant the above permit as per terns therein stated. This
. day of
• , 19 .
BUILDING OFFICIAL
!III It6SI DENCP: LEAST:
Joan 1.. Savage
625 G25_ 1675 ____ -o. I. al, e 1 1,,,1 - Porter ooley_
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1.. This Lease may be extended from XtrtgiC1 IY-q1 Fnth upon the mutual
agreement of both Landlord and Tenant.
2. Termination of this Lease shall require 179 days written notice
by either Landlord or Tenant.
tee ).4,4- f �, /lime r 611
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A. A penalty of $25.00 ma aese against Tenant in each month,
t lf ren payment is / e not made on or before the first day J of the month.
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