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Home My WebLink About02685 _ GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2685 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81801 Phone (303) 945-8212 1. • . Ifearnbt constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or uSpermlt. " PROPERTY • Owner's Name ' Steve & Sherry Kainath Address 0362 Panoramic U.', Silt Phone 876 System Location 0864 County Road 339, Parachute " - Legal Description of Assessors Parcel No SYSTEM DESIGN ZS 0 Septic Tank Capacity (gallon) 0.41/0 £ft , " / /N 10 Percolation Rate (minutes/inch) Number of Bikiroome (or ether) a Ao ttl• qtg 48it eoax I Le a cot 4 D0 win 44-04se 14aposa L. *A kit Required Absorption Area - See Attached/4 .Tior/ re> le triS a /43 4 t(B.0 D/rt-ogeits xr_PA)rrs Special Setback Requirements: Date /2-1041 Inspector ....efianic ihrer d ig FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer r; n Q & Re feIthwti • Septic Tank Capacity / i s- «0 1 tt-9 .C41_ Septic Tank Manufacturer or Trade Name 4 Septic Tank Access within 8" of surface p E. S A Absorption Area /01 0 Absorption Area Type and/or Manufacturer or Trade Name -4 die-1 dc472 - /..)/Li I 1 Adequate compliance with County and State regulations/requirements Other Date 5 - 97 ) • „. - Inspector —Al A S • RETAIN WITH RECEIPT RECORDS AT CONST CTION 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 • IQ INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER ___ icuc- f J 110 WL 1 «16 i 11By � 1 ADDRESS ( n7. I YIAYfl flt l , I>Y. C l) PHONE '1lo CONTRACTOR 6 en( I I A A k d C KS �t In( ADDRESS i'.C13h(3h2 N It) COMle [ o PHONE Re g9' PERMIT REQUEST FOR (i.314EW 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: Near what City of Town fA v (1Q Ii t rite _ Size of Lot 1.a.° -1 — (Le ie.0 Legal Description or Address Cxiat-1 0 b Ikc ox ,t 3 39 Ian vn 0 hi t -le C D WASTES TYPE: (t, DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: vest n(tn 4 1 Number of Bedrooms Number of Persons `l - to ( ) Garbage Grinder (.v'Automatic Washer (7) Dishwasher 501 JRCF, AND TYPE OF WATER SI JPPLY: (-WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: r 1 4 - lwl Was an effort made to connect to the Community System? NO A site plan is required to be submitted that indicates the following MINIMUM distances: Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL, SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOIJT A SITE PLAN GRO! JND CONDITIONS: Depth to first Ground Water Table Percent Ground Slope 2 TYPE OF'INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (,/5 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 Try- L`iva -lv✓ lecxe -- fie WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? Na) pFRCOLATION TEST REST JETS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) 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 purposed 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 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. I Li Signed 1 t ) L - 01 -L4x3 JitL LJCY Date q)III )0(C_ PLEASE RAW AN ACCURATE MAY TO YOUR PROPERTY!! 9311 Ord ?u 3 " 0 - C2 � J / iF .3n 1 Y L Nd , ‘2, 4'P/'hr feg(- v‘zstIr ? /0 40 F/a7/ # UN/TS '7/ J EV'S .;21. "'V