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HomeMy WebLinkAbout03102 i t r 3 ' ` c G ARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N_ ' g • e 109 8th Street Suite 303 A is Parcel No. L ‘ i Glenwood Springs, Colorado 81801 1, Phone (303) 945 -8212 This does not constitute '( ( INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. t' ;r PROPERTY 7 4 Owner's Name h i I A I t1VJ )3 (4t Present Address /, (3k Ow Phone bas-3a15 ' 1 1 C 10 P4€1 Co 8/62) r , ;:y 1 System Location ' ` Lo 3B {ett 0 , ctirtac Q -- ea I Qpacv � , Legal Description of Assessor's a Parcel No . � 1, `%' R_ L tE O 4 6 3 Z Os 55 o S ; F SYSTEM DESIGN y S , I. F Septic Tank Capacity (gallon) Other � , ' r '! t n fi"/ (P ; " 1 6 Percolation Rate (minutes /inch) Number of Bedrooms (or other) ' e # Required Absorption Area - See Attached l t Special Setback Requirements: 1 t ` pate Inspector t 4 f r FINAL SYSTEM INSPECTION AND APPROVAL (as installed) I ▪ Call for Inspection (24 hours notice) Before Covering Installation t it r y System Installer 5 7'AM p/'C C.- ChkrIT. •t" I a �a FIi 3i r Septic Tank Capacity - ( i .71 Septic Tank Manufacturer or Trade Name C O P EC A ,.. 3 ` i ` , ` Y C C c: Septic Tank Access within 8" of surface � 1 e , ✓ ; E Absorption Area a now .4 • S 0 f (O ( 2 t t Xerr ,, ; /N 1 Plc T 4 To 20 vk t 7S %. Absorption Area Type and /or Manufacturer or Trade Name ,; #r r; t• Adequate compliance with County and State regulations/requirements Z/..e' tp, ti . Other ( 1� t .t Date ` I - ( J R In spector 6}-13\ f� V .. ,II RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE ' f *CONDITIONS: ;j( +: 1. All Installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal System Chapter ; ; 25, Article 10 C.R.S. 1973, Revised 1984. r :S 2. This permit Is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- b'�. r ' nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a s t ' requirement of the permit and cause for both legal action and revocation of the permit. 4 I 3. Any person who constructs, alters, or Installs an individual sewage disposal system In a manner which involves a knowing and material 4 variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 8 I' months In Jail or both). White - APPLICANT Yellow - DEPARTMENT • _ _ __ • PROPERTY E • ROAD 1 . PRIVATE X00 C /J\ • • DRIVEWAYI BARN i WET i STOAT/ER OF IT 1 SHEET INDEX , OP:: !EKE PA I !E S' CONC. WALK • NO SITE PLARINDEX,AND GENERAL NOTES l 4 CONC. WALK . --RNrER J* All MAIN FLOOR PLAN I , T ' — Ov O � /L ° ' L L iN °N ra. cP A22 UPPER FLOOR PLAN A23 ROOF PLAN PA A31 EXTERIOR ELEVATIONS ' \ (]USE Y 432 ' EXTERIOR ELEVATIONS ` A41 SECTION CUTS ‘ ■ O'SOR. CONC. PAD A51 INTERIOR ELEVATIONS MO OETNLS 61 SCHEDULES .i ! I. \ LENCN 4 . fCL4 IE KE i , : 500 1LLON 'WATER 0 TANX t WATER GENERAL NOTES 1 . ' i ' All mr5T*Fra AO mESLS 3114L IIE AS DIRECTED BY O MER r0 Mr 10T10AME t MT L L L YLCWE RCCZOSO.YLCELLYSJEMEISMO TIC mow O DOWSE j COWL'IM RESPONS*YE FON M'IMtA & LL NECCESMT INSPECTIONS RED4440 b SLAW MMTT PRIM TO RYERM MY WI POWYS OF NOM ! I TIC MNT4CTOS Rua COIFS MSMER OPERATIONS W TIN SITE TO MIENS L. PER TTE° BY THE OMER. l i Vi TIC A W S SEE Ya OE INSERTED I • CI N NIANOON OYWTIXFREE OF OEMK 5 ^ 1 MO urea EMI 9ACYTRCIOY SNAG 444 E LA MASK MO CEOS AS OF NEW CF MS/ICR OPERATION. NO OMERYO CF THE SUBMISSION l4 SEEN CRAW ONSMME SUSSES SNNA NNW REOLIMIS 1 ORE N50K SNLL TAM PRECEDENCE OER SCALE OF OSRSR0. 1 A NI & LL OKNSGS ME 10 SCE OF STUD WS NOTED OTlEMNSE. .1 FOT : 1 CCLTR.CTT TO RENEE ECT LL WSW. SLLCNLGE O TAMS FOS LW WESCIRCN OM5.1CfOL`NfM.REC[SSED MESAS ILL ono ITEM M R[OMYO l ii Antler's Orchard Development .. Tract 38 8.017 Acres Section 6, Township 6 South, Range 92 i ' West of the 6th P.M. I. t O L b OfKLE005Ls1 1 Realm Noatd®nc©® Not glen �.._.._ __.._.._.._.._.. / - .. SCALE: 1' 75'-0' 11999 �� _ • • 0\ uTuty DAD FENCE .TURE t % • NICE' . 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I "rr tr. a 4C% reduc';o /i fiarc si e dto 11,e7+= , 6) 4 351 ZZ9 3to U I7asc e'5ur veveit 4 z ter C; si t6 /a./ 2 ? /5. s -is frC- IL'r.0 �ctulac.r 6 to U ; �� <S�:� - = t S u� dse /!o cuc -s ° 1 e,ch Thal 5 e zb _ /Doo fJ • Use 2 -I- t-ckr�AL.s e/ 6 an?-Is /o/ • /G 40 dui asi �s • C Min legeraboi, 1.2eLee» edyes of - /rekci6a s • 2 Min. Ca vcr eVer' &o ,C 1h 4 e Clku h 1310 brgaetaufi 4 s R v<;, 1 - Te � 4 ioa 4115.46 9UA2 r 1 -.y - - -- 40,4 4 4 "50-e.4oPg- s6E 8,0 t;.l srru.,; is INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER –±--)w 4 i` �r'n 4Ja - ?9P - S5' 0 8 ADDRESS /2O/ FA- Ave kl-C/c CO PHONE Nom c 6 zs- 32/.r CONTRACTOR SA his As A6o ADDRESS PHONE PERMIT REQUEST FOR (44 W 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 FACH ITY; Near what City of Town Size of Lot 4cr c's Legal Description or Address Ti4c .3 F( A /r i5 Q-cC.t Le ve'°J4. WASTES TYPE: (WELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: Number of Bedrooms Number of Persons (Garbage Grinder ('Automatic Washer (iDishwasher 5OIJRCE AND TYPE OF WATER SIJPPT,Y: ((WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 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 DISPOSAI, SYSTEM PERMIT WOd, NOT BE ISSILED WITHOUT A SITE PLAN. GROI JND CONDITIONS: Depth to first Ground Water Table &e4 +4G, Z - Percent Ground Slope 2 • 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 DISPOSAL BY: ( ) ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION (A UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER - DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? NO PERCOLATION TEST REST MTS. (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) f! L/ Minutes 17 per inch in hole No. 1 Minutes 7 per inch in hole NO. 3 Minutes A per inch in hole No. 2 Minutes per inch in hole NO. Name, address and telephone of RPE who made soil absorption tests: C TG 7 v cv' 2 3`-/ Le -14cr &, G/e.,,a.f 5p €• eC7 53 6o/ ?7n- ?VS 28cf Name, address and telephone of RPE responsible for design of the system: (�uJne/ 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. Signed tt l ' Date i 4 1 / /? 5 7 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 A Z ..< 0 5 i n 1 5- / \/ ..k. / 7 0 [ / / 0 / , 2 / f 7 % ® . Iv 5' \ \ n ƒi( a = ® 0 /\ nn, r< a \\ \ § [ @E/ 0 Ss 7Rƒ\ co ,. , { . \ 7 \ CD t-ty CD 0 ƒ7 \ k§ a& } g o Q §. 2 . c \ / i (/ c @ƒ . 6 ® ±t \ t \ \ ° aN En }