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Home My WebLink About02875 3i t �"'+3xi T"a� , K :s� e .M': , .s.'' ,. ( ink :.,.Arr^� ii 1 `743 -/3r7 3 b `j -2-- 91/ 5 0 • GARFIELD COUNTY BUILDING AND SANITATION , DEPARTMENT Permit 287 a 109 (ith Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945-8212 • This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERM a building or use permit. PROPERTY Owner's Name Gerald I. Tfmlas P resent Address 0174 CR 126 Glenwood Phone 945 -4413 System Location 0174 County Road' 126, Glenwood Springs Legal Description of Assessor's Parcel No. 9 I) FLOC - GEACk - 13 et° 'Lour -? n 1 6{ ft or Patti ss 0 , if CtoaAdEn PO lo 2S� SYSTEM DESIGN 6 p r t' y 6 1) 1 " T AtNCCfES 1 2SO if Pr „ CM `1) 1• `a en- R •� �1 Septic Tank Capacity (gallon) Other • 't Geo >a' it e1,1 - N J /` Percolation Rate (minutes /inch) Number of Bedrooms (or other) 4 • Required Absorption Area - See Attached Special Setback Requirements: Date 1 0 – 1.3 – `17 Inspector Act fY FINAL SYSTEM INSPECTION AND APPROVAL (as installed) 1 Call for Inspection (24 hours notice) Before Covering Installation System Installer Joe t p M O i A - Septic Tank Capacity 1 2 S O A � Septic Tank Manufacturer or Trade Name C Q r t 1 4 t . ' . - / • / - Septic Tank Access within 8" of surface / E,$ Absorption Area G t T o isR el) 7 rwHC Pi c S Absorption Area Type and /or Manufacturer or Trade Name 1 M plc 7 ti-A7 O as (c Adequate compliance with County and State regulations /requirements ' Y es Other e Date �•Q _ V A J Inspector a g c 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'R.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 e 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 -8 months in Jail or both). White - APPLICANT Yellow - DEPARTMENT PQWER A EQUIPMENT COMPANY ( ^OW•• eIu°••••• CO. ) DENVER GRAND JUNCTION CASPER ALBUQUERQUE 303 - 288 -8801 303 -243 -0722 307 - 577 -9700 505 -344 -9488 303 -288 -8809 FAX 303- 243 -0728 FAX 307- 577 -9703 FAX 505 -345 -4715 FAX 800- 883 -9284 800 -898 -7319 800 -883 - 9275 800 -880 -2320 , r - TJ 1 ie., - 0 • c .. f CEDARAPIDS • CHAMPION • EL JAY • EAGLE • EUCLID • HITACHI • HYPAC PREMIER - PEERLESS • RAMMER • VOLVO CONSTRUCTION EQUIPMENT ACCESSORY LINES BRUNNER & LAY • BUCYRUS BLADES • COLUMBIA STEEL • CUMMINS DIPACO • HELSER MACHINE PARTS • INTERTRACTOR • IRATHANE SYSTEMS KAWASAKI • LUDLOW- SAYLOR • MINNPAR • SPOKANE STEEL FOUNDRY SUPERIOR CONVEYOR PARTS • WEG ELECTRIC MOTORS • WESTERN WIRE t INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION • OWNER (7 C� 5 • /o 455o ADDRESS 0/ 7/ / 4 / Ola> PHONE ,9 1 /5 - W/3 CONTRACTOR N tOt � I9ft? QR J ADDRESS 10 AVi p/y PHONE 9a7327 PERMIT REQUEST FOR ( ) NEW INSTALLATION ( ) ALTERATION REPAIR Attach separate sheets or report showing entire area with respect to surrounding areas, topography of rea, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 41. LQCATION OF PROPOSED FACILITY: p/. , U Near what City of Town OZIfi/ ,(/ .O��/ Size of Lot /O / ( Legal Description or Address L54 : , //Q / (/! T WASTES TYPE: X DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ("` NON - DOMESTIC WASTES ( ) OTHER - ` DESCRIBE - BUILDING OR SERVICE TYPE: ND6� // Number of Bedrooms Number of Persons (D X Garbage Grinder pc Automatic Washer (Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ( ) SPRING ( ) STREAM OR CREEK \ � If supplied by Community Water, give name of supplier: Ww t 1 \( L� (� DISTANCE TO NEAREST COMMUNITY SEWER SYSTE : NV4 I 0 \ 9L- DC Was an effort made to connect to the Community System? 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 WITHOUT A SITE PLAN. CROlIND CONDITIONS: —^ _ Depth to first Ground Water Table 1 S C 1 I' `� (( ( Percent Ground Slope 2 • TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 9( 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 WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? pERCOT,ATION TEST REST TITS: (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. LagA ��°1,� � �y Signed /� �1 Date 1 / 7 PLEASE DRAW AC�CL7RATE��l YO O1 TY!! f,7 7Z5z5Q 3 • • • eeo; 674 r:ec7 O EXHIBIT A L c k\ 1 ti l t\ Roi • .': H %:j,- �:"r,;•:- . ::e' =T. ^Year= : ?, ° +;; 5wh8tkNE:, Section 9, Township 7 South, Range 89 Nest of the 6th ( Principal Meridian. TOGETHER with a 60 foot easement situated in !�(� C• Lot 1 of Section 9, and Lot 1 of Section 10, all in Township 7 w J South, Range 89 West of the Sixth Principal Meridian, being 30 feet on each side of the following described centerline: • Beginning at a point on the Northerly line of said Lot 1, of said Section 9, whence the Northeast Corner of said Lot 1 bears: • S. 89'46'0 E. 647.07 feet; thence along said centerline 5. 16'02'31" E. 159.98 feet; thence 35.06 feet along the arc of a curve to the right, having a radius of 47.86 feet, the chord of which • bears: 5. 69 ° 51'40" E. 34.28 feet; thence S. 48'52'31" E. 108.05 feet; thence 76.42 feet along the arc of a curve to the left, having a radius of 104.75 feet, the chord of which bears S. 69 E. 74. feet; thence U. 09'19'29" E. feet: thence 116.47 feet along the arc of a curve to the left, having a radius of 196.66 feat, the chord of which bears: N. 72'21'29" E. 114.78 feet; thence N. 55'23'29" E. 147.76 feet; thence 101.36ffeet along the arc of a curve to the right 94.95 having feet; thence S. 53'21''35 " E. 112.29 o feet; c then s 0 03" ce67.57feet along the arc of a curve to the left, having a radius of 105.02 feet, :•: mrl ystrxw.m'i A.D iW 6t the chord of which bears: S. 71'47'30' E.. 66.41 feet, more or Tess, t• a point on the Westerly right of way line of the Four Mill County Roo. • as constructed and in place. • •` COUNTY OF GARFIELD STATE OF COLORADO • • • JUL b( '7( 1j 1.H4_1 F't ' Nia : : I c g ; i Cr el rfrt t 4 _ . -----> t , r ‘,..., ... ,... 7,,,, ,.... ...., ( i. t. r - \ \\\ \\\\ -t, Ilk I c " I k. 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