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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945.8241
INDIVIDUAL SEWAGE DISPOSAL PERMIT
Owner Austin Marquis
System Location
1244
This does not constitute
a building or use permit.
0956 County Road 1.12 Carbondale
Licensed Installer John Legg
Conditional Construction approval is hereby granted for a 750 gallon
XX Septic Tank or Aerated treatment unit. Lt. r-,-.41:,,,___
Absorption area (or dispersal areal computed as follows: 1/1�0�''-VE-t}�el (C �%a
Perc rate of one inch in 0.2-- minutes requires a minimum of Z-1 1 sq ft of absorption area pet bedroom.
Therefore the no. of bedrooms 'ix amu_ sq ft minimum requirement = a total of Esq ft of absorption area.
May we suggest 1Z ty36/x3/
Date ) 115-7-
FINAL APPROVAL OF SYSTEM:
Inspector -TL_'.—L14-
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover-
ing any part.
Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
C> e-•- Proper materials and assembly.
rade name of septic tank or aerated treatment unit./O0C9
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date
Other
-
Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
`CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 66-44-4, CRS 1963, amended 66-3-14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements.
Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viola-
tion of a requirement of the permit and cause for both legal action and revocation of the permit.
3. Section III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in-
volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class 1,
Petty Offense ($500.00 fine -- 6 months in jail or both).
Applicant: Green Copy Department: Pink Copy
//j7y•
A Cris?;: SS
APPLICANT _N1
ADDRESS
CONTRACTOR r#Re .G'
ADDRESS _ 4,,a47
IS PERMIT FOR: ( ) New Installation ( ) Alteration ( ) Repair '
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of area, habitable buildings, location of potable water wells,
soil percolation test holes, soil profiles in test holes.
LOCATION OF PROPOSED FACILITY: County __Y_ ► -
;c r. what .City or Town __ _ , / t-, Lot Size
Legal Description _ -e9. 'o _----ems 6/ �---
PHONE 3•
a
PHONE
PHONE 2_I -� `
WASTES TYPE: (✓TDwelling ( ') Transient Use
-�- -- --- ( ) Commercial 'or ins.ti.tutianal ( ) Non-domestic Wastes =
( ) Other - Describe:
BUILDING OR SERVICE TYPE: Number of Persons
Number of Bedrooms ) '
( ) Garbage grinder ( ) Automatic was)pr ( ) Dishwasher
'
SOURCE AND TYPE OF WATER SUPPLY: ( well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: 1.
If supplied by community water, give name of supplier: -
GROUND COND11IONS:
Depth to bedrock: / Oci)
Depth to first Ground Water Table
Percent ground slope: ,/ `
DISTANCE TO NEAREST COMMUNITY EWER SYSTEM: f )W'
Was an effort made to connect to community system? e2
TYPE OF I! VIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
Aeration Plant ( ) Vault
Composting Toilet ( ) Recycling, potable use
Incineration Toilet ( . ) Recycling, other use
Other - Describe: T/ .-6 t9/..-,`,.) -..r,`-' I"
r'
( ) Septic Tank
( ) Vault Privy
( ) Pit Privy
• ( ) Chemical Toilet
FINAL Dig SAL BY:
(• Absorption Trench, Bed
( ) Underground Dispersal
( ) Above Ground Dispersal
( ) Other - Describe:
or Pit ( ) Evapotranspiration
( ) Sand Filter,
( ) Wastewater Pond'
itl., `a r•r. DISCI;-.;UDP;r:fCTLY 1%10 01 i : SlA1E•
151SiiM IS Uf-S)GNFD FOR 2--.._____________�----
ed byRegistered stered Profess i onal EnF (RPE), state
If �.,e system is to be design � g �ircer { )
rate of absorption in test holes shown on the location map, in minutes kr inch
of drop in water- level after holeshave been soaked for 24 hours:
SOIL PERCOLATION TEST: RESULTS: t i_s1 .i`;
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.
Nrme, address, and telephone of RPE who made soil absorption tests:
-game, address, and telephone. of RPE_ responsible for design of the system:
Applicant ackriowledge:_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 Trade and, furnished by the applicant or by
the local health department,-forpurposes 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 adopted under Article 10,
Title 25, C.R.S. 1973 as amended. The undersigned hereby certifies that all
statements made, informationand 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 issuing the permit applied
for herein. 1 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 perju, as•provided bylaw.
Date Signed
PLEASE DRAW AN ACCURATE I'iAP TO YOUR PROPERTY
De to
'fester 1
� 1
Address
a/
�41
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PERCOLATION TEST DATA
04f 4--‘o 1-(1.„ (2-c(
Profile hole ike-r/_( ,y..,( ��-
S
TEST HOLE
#1
#2
#3
TIME (Min.)
Level
Drop
Level
Drop
Level '
Drop
qX1
el/"
so4
3���6
f
�'
%6 f'
/r51
7 /
4',,
10
I
7
114
Xll1A"
/lam
15
4i(
G
%/z
X 1
�((
"7 z
�r
1 4
G y
/lIa
�(y f
� �f'
7l
?../,;,�9
6 l/
20
25
D fX
X
7
X i'6/
V3
30
/
XV
6%
% '`
6 /
A "
35
40
45
50
•
55
a
60
Percolation Rate
minutes per inch.