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' 4 i `'- - GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N 3 2 1 n e •
109 6th Street Suite 303 Assessor's Parcel No. t i
4 Glenwood Springs, Colorado 81801 t I
) t Phone (303) 945 -8212 I , '
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This does not constitute
1 t - INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
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( ; Owner's Name Present Address ( � Phone . i
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‘ et S y System Location
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Legal Description of Assessor's Parcel No. ^ ) _ /r 'r {
K tea- e e� E ��/ 7T/'/ ,, r i. SYSTEM DESIGN ` = A w _ Fits"
• R ; /0 oo S / alit Tank Capacity (gallon) Other qy�
', dry
# t / � ICl � Percolation Rate (minutes /inch) Number of Bedrooms (or other) p/.2...,, . s , it
Required Absorption Area - See Attached . .�
Special Setback Requirements: � ? (f �
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if } • �`�-�� Car / / Inspector (/' v u `,.
C. FINAL SYSTEM INSPECTION AND APPROVAL (as Installed) J
it
`r ' Call 'for Inspection (24 hours notice) Before Covering Installation
> 1 System Installer C ' ` FLAP) ' f
Septic Tank Capacity / COO (/� - -- ..'
r ,F Septic Tank Manufacturer or Trade Name ` (�� t L- 'rp " "
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Septic Tank Access within 8" of surface ',
k .f Absorption Area z LtFI1,77rw, tr/1 t'
- Absorption Area Type and /or Manufacturer or Trade Name I '<< a/ 1
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6 Adequate compliance with County and State' regulations/requirements 4 t
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V Other
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C.
Date (o 2.3 Ins pector Q 4
4 p RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 1
*CONDITIONS: 3 `: :
5 f 1. All installation must comply with all requirements of the Colorado Staf / 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- d ■
' ? 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 ."
:Jr variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 '
t months in )ail or both). -
4`r __ —v_`_ White APPLICANT Yellow - DEPARTMENTv�__��__�-- �___��
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER Rnhert. W. & Ann T,. Ramsey
New Castle CO 81647
ADDRESS 7300 County Road 313 P.O. Box 430 PHONE (q7n) 379 -5733
CONTRACTOR Owner
ADDRESS (Mailing) P.O. Box 430 New Castle, C08164PHONE (970) 379 -5733
PERMIT REQUEST 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).
LOCATION OF PROPOSED FACILITY:
Near what City of Town Silt & New Castle SizeofLot 40 acres
Legal Description or Address 7300 County Road 313
WASTES TYPE: (X) DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: Log Home
Number of Bedrooms One (expandable to two) Number of Persons Two
( ) Garbage Grinder (X) Automatic Washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (X) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Approximately 20 mi les
Was an effort made to connect to the Community System? N/A (No)
A site plan is required to be submitted that indicates the followine 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.
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
2
r
V TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(X )- 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:
( X) 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? .NO
PERCOLATION TEST RESULTS: (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
W • ; • o u srepresen . tion may result in the denial of the application or revocation of any permit granted based
upon sall t o ,.lication and • legal action for perjury as provided by law.
Signed 1 �• ��_�. Date CD 12q
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
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DIRECTIONS TO OUR PLACE (coming from the West):
Take Silt exit (exit 97). Turn right at stop sign (away
from Silt); then almost immediately, turn left on the River
Frontage Road. Go about 's mile, past a large metal building on
your right, and then turn right on County Rd. 311 (Divide Creek
Rd.). Go } mile on this road, crossing over the Colorado
River, past Davis Lumber on the left, to where the road forks.
Go left here for 1.3 miles, past a gravel pit on the left, then
across a bridge over Divide Creek and a brown house on the
left. _Just past this bridge and house, Divide Creek Rd (311
Rd.) will cut off to the right. Turn here, and follow 311 Rd.
for 7.1 miles; the last 9/10 mile will be gravel. The road
forks again after 7.1 miles. Take the road on the left. This
(� 06 is East Divide Creek Road (County Rd. 313), and follow 313 Rd.
o ix CY `p p for 7.3 miles to our place. You'll pass Spring Creek Ranch on
the right, a large log home up on a hill on your right, Spruce
(` Crossing (a stand of dense Spruce trees with a cattle guard),
\n the - Often Cabin on the right (an old square hand -hewn log
cabin), and then you'll come to a post & pole fence crossing a
meadow, on your left. That's the beginning of our property.
Keep going, past our metal gate (you can see our home up on the
hill from here) to the post & pole fence and gate. Come
through the gate, over the bridge, and up the road to our
place. We're about 's mile off the county road.
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