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Home My WebLink About02658 ' 3t 1';`At r C TW.47. '710,M1ii wiri ' 9,.- C '�. v;' i� o't tk-. tt 1 • 11 1 . 11 F .�. • n, f- - GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2 6 5 8 109 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 Bob & Marilyn Hirst Present A ddress 9415 Hw 325 Rifle _ Phone System Location 9415 Highway 325, Rifle Legal Description of Assessor's Parcel No. SYSTEM DESIGN A Septic Tank Capacity (gallon) �. Other A 't 4, *1- OA / ": /2 2 SEE PERMIT 1 ISPercol Rate S mutes /inch) Number of Bedrooms (or other) Ca ite r. { .t c( ) Required Absorption Area - See Attached / /Ni767.1t Special Setback Requirements: Date Inspector - FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer 14Y# corm S0V - .TONro10V /t300 Septic Tank Capacity GA Septic Tank Manufacturer or Trade Name 6f/Z99 .4N/) G Septic Tank Access within 8" of surface 165.5 Absorption Area o ,t2 7 , / `J )VflhI" ,2.s7 0 Absorption Area Type and /or Manufacturer or Trade Name /b P / Adequate compliance with County and State regulations /requirements Other q V ��xe.< Date 2 /y -7 6 Inspector ‘ 71/4 E 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 )ail or both). White - APPLICANT Yellow - DEPARTMENT ate. r INI21VI JAI, � SEW E ACG SYSTEM AJ'PLICATION OWNER O rs T , 7 >04 /,' -f L4 n� ADDRESS / u1 c Sr� S / P ONE CONTRACTOR w,a - =e3=- _ Ili. /NM . l i7EJJIMi� S�) ADDRESS %/1st+ r �r� ,�_- - -_ PHONE 92r3 5.r 6 J Q �� PERMIT REQUEST FOR NEW INSTALLATION () ALTERATION () REPAIR 4 - g ')�5 Attach separate sheets or report showing entire area with respect to surrounding areas, topography of arca, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4). / � LOCATION OF PROPOSED FACILITY: COUNTY C� '/i`r..-- Near what City or Town Lot Legal Description WASTES TYPE: SDwelling ( ) Transient Use ( ) Commercial or Industrial ( ) Non - domestic Wastes ( ) Other - Describe BUILDING OR SERVICE TYPE: Number of bedrooms: Number of persons ( ) Garbage Grinder ) Automatic Washer ( ) Dishwasher SOT JRCE AND TYPE OF WATER SI IPPLY: �L� �/ ( ) SPRING () STREAM OR CREEK Give depth of all wells within 180 feet of system: If supplied by communtty water, give name of supplier: GROI JND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent Ground Slope: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: A1/4 Was an effort made to connect to community system? TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 4 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: Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand Filter ( ) Above Ground Dispersal ( ) Wastewater Pond ( ) Other - Describe: ,J WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? /V/1 J!.. r• • SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer) 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 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 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 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. Date �3/ � Signed SASE PRA AN ACC1 JR ATE MAP TO YO1 JR PROPERTY N T tEC 1 rn • O Oo O JCS A V VW a D AS rn cR t 1 1 N t i tt \ - ci t t•3 th Z c 6 a' 2 o - r 2 � " .3.% c) o r- VW H CT( \lA S N Z - , u_. \' rnM4Niin� „y;., ^Rtl- FY ^'%PS }S, (,a Y^. % >,.^mo t.. +i.N 1 ::.f dy':�fli:.r r t . Fc.;..J. ' fri th GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT re, 109 8th Street Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT ii14 1 889 a building or use permit. Owner 9415 liwy 325 Rifle System Location 1.o her t Kelley Licensed Installer __ uuner • Conditional Construction approval is hereby granted for a . - gallon 7 r) � 1 — Septic Tank or — Aerated treatment unit. t Absorption area (or dispersal area) computed as follows: Perc rate of one inch in / ”- minutes requires a minimum of sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms 1 x --' sq. ft. minimum requirement = a total of sq. ft. of absorption area. May we suggest: -_ / .. F.. '- i „ Date Inspector -- FINAL APPROVAL OF SYSTEM: i-e? -9 J Z y � �� Q` No system shall be deemed to be in compliance with the Sewage Disposal Laws til the assembled system is approved prior to cover• ing any part. _ Septic Tank access for inspection and cleaning wi in 12" of ground surface or aerated access ports above ground surface. - Proper materials and assembly. �j1 p Trade name of septic tank or aer. -d treatment unit. U Adequate absorption or . pei sal) area. np! Adequate complia e with permit requirements. �.+" Adequate co pliance with County and State regulations/requirements. Other Date Inspector — - -- _ RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE •CONDITIOHS: 1. II 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. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation of 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.). Applicant: Green Copy Department: Pink Copy