HomeMy WebLinkAbout02703 /,*
GARFIELD COUNTY BUILDING AND SANITATION WPARTMENT , Permit 2 7 Q 3
109 8th Street Suite'3 A rs Parcel No
Glenwood Springs, Colorado 81801 ..
Phone (309) 945.8212 ,. _,
I This does not constitute
a building or use permit. I
INDIVIDUAL SEWAGE 'DISPOSAL pEHMIT
PROPERTY /
i
N `
Owner' Name
Norman Charles Wayman present Address 1333 Rock Court, Carbondale 961-4366 6
System Location,
era County Road' 110, Carbondale
Legal Description of Assessor's Parcel No. .
SYSTEM DESIGN
/So Septic Tank Capacity (gallon) Other G
j / Q 4 a e /s Ave Dtcp�6
I" /U le ✓b/N Percolation Rate ( inutes/inch) Number of @edroomgr(or qlh ) D,s AL /O Z
Required Absorption Area - See Attached /? $.1 - jN fl
FsL4To 4N/75; / a;
/az :316 J /Ffvseas
Special Setback Requirements:
Date/ '�� 9 - 'Lo Inspector /�� c c.
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer P)t sJ_n . E Q
Septic Tank Capacity Ache>
Septic Tank Manufacturer or Trade Name C4. G o
e ,;r Septic Tank Access within 8 of surface W-S
Absorption Area 12 . 3 5
Absorption Area Type and /or Manufacturer or Trade Name /.7 3S"
UM r74 1 NTi2f/zNTdtt.-
■
f; Adequate compliance with County and State regulations/requirements 7 66- (,-
Other . �
/ - 4.— Inspe /4 s. , k...• /m te,
Date v , tore,
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 -
s 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. from the terms or specifications contained sewage disposal system
contal e application iin the picatin of permit a Class I, Petty Offense ($500.00 fine material
variation 8
months in fail or both).
White - APPLICANT Yellow - DEPARTMENT
1
Sep - 23 - 96 09:4bA Stella Archuleta 970- 945 -1555 P•02
r
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
oWT'r R NO Prna1.1 CliAK
lS'S ..a . A MAht 1 66
ADDRESS 1333 ' •ck- COUP -T- PHONE 17 0 9 6 1
K a' Q 1` °l. K A -R_Nis ,t
('Oti l'KAC'POK I A�K/ NO e o �� 4-7. ADDRESS ._hL4 7/ ST Co il - I3yiYDa L ca PHONE e 6
8/L2
PERMIT R6( PEST FOR )
(X 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)
•.a • Ai ':O'.
Near what City of Town
G 0 S,I1J&S Size of Lot
Legal Description or Address, I -6 DISGRt?TO' r5 ATT/ -CYCP
WASTES TYPE ( ✓) DWELLING
( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE S I/J GLF F+4t) L-r e gS7PFS YcE —
Number of Persons } ___
Number of Bedrooms
(.--1 Garbage Grinder (✓Y
Automatic Washer (✓- Dishwasher
Okla _ 1� .1 y l -WATER SUPPLY. (WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied h ( otnmunity Water, give name of supplier:
DISTANC1 . 10 NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System? egt4aZa GRi5geN BURCr
c.A.7rt cg .cac 4.0A10.C.
Asitep NA) ► I • • • Leach Field to Well: OPt L-o 100 feet
Septic Tank to Well: 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System to Property 1 ines: 10 feet
YOUR INDIVIDUAL SFWA(-E DISPOSAL SYSTEM PERMIT WILL NOT RE ISSUED
WITHOU.LA. ice. ; fl.A �,
GROI IND CO1j1ZL1Qt 3
Depth to first Ground Water Table -
Percent Ground Slope
2
Sep -23 -96 09:45A Stella Archuleta 970- 945 -1555 P.03
a --
r +
TYPE OF INDIVIDUAL SEWAGE DISPOSAL. SYSTEM PROPOSED
(A SEPTIC TANK ( ) AERATION PLANT ( ) VAULT
( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABI,E 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
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE ?�
PERCOLATION TEST RF.SI ILTS: (To be completed by Registered Professional Engineer, if the Engineer does
the Percolation Test)
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 acknoA+ ledges that the completeness of the application is conditional upon such further mandatory and
additional tests and f eports as may be required by the local health department to be made and furnished by the
applicant 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.
Signed Date
PLEASE DRAW AN ACCURATE MAY TO YOUR PROPERTY!!
3
JAUG -2y96 TUE 11:09 AM SMOTHERMAN & ASSOC FAX NO. 9709630575 P.01
SCHEDULE A
Order Number: 96025631
LEGAL DESCRIPTION
7 South, eRanged88 W. of the n 6th t Principal l hip containd Meridian, described
as follows:
Beginning at a point whence the East 1/4 corner of said Section
7 bears North 48 degrees 20.03" E. 1495.02 feet]
thence S. 43 degrees 14'48• W. 138.66 feet]
thence S. 19 degrees 48'41" W. 171.13 feet]
thence S. 67 degrees 35'25" W. 104.92 feet; Road]
thence West 153.25 foot to the Easterly ROW of the County
thenoe along the East ROW of the County Road N. 1S degrees
08'00" W. 561.72 feet]
thence along the said ROW N. 02 degrees 10'00" W. 43.67 feet]
thence N. 50 degrees 49'09" E. 22.00 feet]
thence N. 30 degrees 54'55" X. 194.88 feet]
thence N. 63 degrees 11'05" E. 46.69 feet]
thence S. 74 degrees 40'36• E. 137.98 feet]
thence S. 53 degrees 40'14" E. 116.00 feet]
thence S. 64 degrees 11'22" E. 65.09 feet]
thence N. 81 degrees 16'15" E. 72.92 feet]
thence N. 36 degrees 25.28" E. 25.39 feet]
thence S. 03 degrees 02'40" E. 384.56 feet to the point of
beginning.
COUNTY OF OARFIELD
STATE OF COLORADO
TOGETHER
ec rded a l0 3 , for ingress
at Page Reception No. 305307.
deed speciald al use Also special permit for roadway from County Road 110 to the easement.
above.
41. . , - L
I;? 5 - 94- 4: / 5 - .:2 ; iS , n,
0 GY _ la te (01 ,T 3 < ��
�S / 8 9
a ., - � �
F-9-( >C / /, c 9 1 a Z / = '/, 4. r„,0
At ,__9 1 " i N $` m /,v