HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8t Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.earfield-countv.com
TYPE OF CONSTRUCTION
❑ New installation
WASTE TYPE
ONSITE WASTEWATER
TREATMENT SYSTEM
(OWTS)
PERMIT APPLICATION
0 Alteration
C"Dwelling 0 Transient Use 0 Comm./Industrial
0 Other Describe
"Repair
0 Non -Domestic
INVOLVED PARTIES
Property Owner: 9, arvn
Mailing Address:
Contractor: ,0
Mailing Address:
$s
5eb, era 9
Phone: ( 470) 1p 9— �IoUrs
S, 81057-
S ruiCx_S1Lfrl' Phone: (C'7O) 33? -ti i'7 y
(Pa god(' 3691 0,, Co gl(o3)
Engineer: Phone: (__,)
Mailing Address:
PROJECT NAME AND LOCATION
Job Address: $ S S -e r e c A. S r ti 1, (r)
Assessor's Parcel Number: d 179
Building or Service Type: Or`vrtu,„.
Distance to Nearest Community Sewer System:
Sub. Lot O 7 Block (0__/
#Bedrooms:
Ag
3 Garbage Grinders
Was an effort made to connect to the Community Sewer System:
1 P` Septic Tank 0 Aeration Plant 0 Vault 0 Vault Privy 0 Composting Toilet
0 Recycling, Potable Use 0 Recyding 0 Pit Privy D Indneration Toilet
0 Chemical Toilet 0 Other
Depth to 1 Ground water table Percent Ground Slope
Type of OWTS
Ground Conditions
Final Disposal by
Water Source & Type
Absorption trench, Bed or Pit Underground Dispersal
r._
Effluent
CI
D Evapotranspiration 0 Wastewater Pond 0 Sand Filter
Above Ground Dispersal
O Other
"Well 0 Spring 0 Stream or Creek
0 Cistern
O Community Water System Name
Will Effluent be discharged directly into waters of the State?
0 Yes No
AA c1rit
CERTIFICATION
Applicant acknowledges that the completeness of the application is conditional upon such further
mandatory and additional test 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 legal action for perjury
as provided by law.
hereby acknowledge that 1 have read and understand the Notice and Certification above as well as
have provided the required information which is correct and accurate to the best of my knowledge.
-110 110-L-1
Property Own r Print and Sign
6/ // b
Date
OFFICIAL USE ONLY
Special Conditions:_
?Zit-itt-Ziski:r11— Di41
Permit Fee:
'� CD
Perk Fee: Total Fees: Fees Paid:
E�iZ 15 9-. 75.
Building Permit
1D I R
l
Septic Permit: /_
~ ~ rZ ?io
Issue te: Balance Due:
017-1 v(
BLDG DIV:
•111111P
S -12. -2Q/5 -
22Q/5 -
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APPROVAL
APPROVAL
DATE
d s• "5 co
�o90 aS —
5/8/2015
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25017-2C
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QESIGN NOTES
• Design per performance test per AS1M
C1227
• Top surface area 56.25 ft=
• f'c 0 28 days; concrete = 6,000 PSI
Min.
installation:
• Tank to be set on 5" min. sand
bed or pea gravel
• Tank to be bockfilled uniformly on
all sides in lifts less than 24 and
mechanically compacted
• Excavated material may be used for
backfill, provided large stones are
removed
• Excavation should be dewatered and
tank filled with water prior to being
put In service for Installation with
water table Tess than 2' below grade
• Meets C1644-06 for resilient
connectors
• Inlet and Outlet identified above pipe
• Delivered complete with internal piping
• PVC or concrete risers available
• Secondary safety screen available with
PVC riser
• Option of pump or siphon installed
ALLOWABLE BURY
(Based on Water Table)
WATER TABLE
ALLDWABLE
EARTH FILL
0'-0-
2'-0"
1'-0"
3'-0"
2' - 0"
3' - 0'
3'-0"
4'-0"
DRY
4' - O"
Section
View
Digging Specs Invert Dimensions Net Capacity Net Weight
13' Long x 7' Wide Inlet Outlet Length Width Height Inlet Side Outlet Total Lid Tank Total
56" below inlet 56" 53" 135" 60" 68" 843 gal 416 gol 1259 gal 3120 lbs 10880 ibs 14000 lbs
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