HomeMy WebLinkAboutApplication- PermitGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY (�(
Owner's Name i �� �� Present Address 'J" '
System Location 1 V�v—S 1L4
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Legal Description of Assessor's Parcel No
SYSTEM DESIGN
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Permit A.
Assessor's Parcel No.
This does not constitute
a building or use permit.
Phone \ V "(I vL1
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback Requirements:
Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity
6A e,
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface
Absorption Area
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Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other
Date - Inspector
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 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-
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 material
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6
months in jail or both).
White - APPLICANT Yellow - DEPARTMENT
GARFIELD COUNTY SEPTIC PERMIT APPLICATION
108 8th Street, Suite 401, Glenwood Springs, Co 81601
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
www.garfield-eounty.com
1
Parcel No: (this information is available at the assessors office 970-945-9134) I,n ` D1,\- 6'
2
Job Address:(if an address has not been assigned, please provide Cr, Hwy or Street Name & City) or and legal description
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Lot Size: Lot No: Block No: ' Subd.l Exemption:
34 A i.. -es .Ph:
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Owner: (property owner)
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Mailing Address 6 i64
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Contractor:
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Mailing Address
Ph:
Alt Ph:
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Engineer:
Mailing Address
Ph:
Alt Ph:
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PERMIT REQUEST FOR: (X)_ New Installation ( ) Alteration ( ) Repair
8
WASTE TYPE: ¢()Dwelling ( )Transient Use ( )Commercial or industrial ( )Non- Domestic wastes
( )Other — Describe
BUILDING OR SERVICE TYPE: j be 1,e5.‹_ h c. / r' /)
9
Number of bedrooms j Garbage Grinder ( )Yes NNo
10
SOURCE & TYPE OF WATER SUPPLY: (WELL ( )SPRING ( )STREAM OR CREEK ( )CISTERN
COMMUNITY WATER, name of supplier:
If supplied by give
COMMUNITY SEWER SYSTEM:
11
DISTANCE TO NEAREST
to the Community System?
Was an effort made to connect
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12
GROUND CONDITIONS:
Depth to 1st Ground Water Table Percent Ground Slope
13
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED:
Cs)Septic Tank ( )Aeration Plant ( )Vault ( )Vault Privy ( )Composting Toilet
( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy ( )Incineration Toilet ( }Chemical Toilet
Describe
( )Other-
FINAL DISPOSAL BY:
( )Absorption trench, Bed or Pit (X)Underground Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter
( )Other- Describe
14
( )Wastewater pond
15
Will effluent be discharged directly into waters of the state? ( )YES ,(Z )NO
16
PERCOLATION TEST RESULT: (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._
& RPE who made soil absorption test:
Name, address telephone of
RPE for design of the system:
Name, address & telephone of responsible
17
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 actionfBr perjury_as provid by law. -
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OWNERS SIGNATURE
z
DATE
Permit Fee:
73. 00
Septic Permit #:
Buildi�g & Planning Det:
lei `/fir—
STAFF USE ONLY
Total fees:
Perk Fee:
(_JE' . 00
LALcA-c)
Building Permit #:
Issue Date: f�
6�'s�/fP
APPROVAL
DATE
Garfield County
Building & Planning Department
ALL APPLICATIONS ARE REQUIRED TO BE SUMBMITTED IN PERSON
PROCEDURE REQUIRED FOR COMPLIANCE WITH THE GARFIELD COUNTY SEWAGE
DISPOSAL REGULATIONS.
Permit applications can be obtained and submitted to the Garfield County Building and Planning Department
at 108 8th St, Suite 401, Glenwood Springs, Colorado. See below for additional information.
I PERMIT APPLICATION & SUBMITTAL REQUIREMENTS:
• Complete application.
• Site plan (1 copy) to include well, all streams, irrigation ditches, and any water courses. Draw in
your house, septic tank & system, detached garages, and driveway. If a change of location is
necessary, you must submit a corrected drawing.)
• Engineered System will need copy of perk rate & design for our records prior to final inspection.
FEES:
Make Check payable to: Garfield County Treasurer
• Septic Permit for a New installation $73.00
• Septic Permit for alteration and/or repair ,,, $50.00
• Septic Perk test $100.00
FEES ARE NOT REFUNDABLE.
II ATTACHMENTS:
• Percolation Test Instructions
• Recommended minimum requirements for Individual Sewage Disposal System (ISDS).
III FINAL INSPECTION:
• When all components are in place, connected and ready to cover, request a final inspection by the
County Inspector.
• DO NOT backfill any part of the system prior to the inspection.
• The initial fee covers the percolation test and one (1) inspection before cover up. Any additional
percolation test will be charged at $100.00 each and additional inspections will be charged at
$50.00 each.
• Upon final approval, carefully cover the entire system.
• Engineered Systems are inspected by the Engineer prior to backfill. A final sealed letter by the
Engineer is required to be submitted to Garfield County.
DESIGN REPORT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM
CHAIR BAR ROAD
TAX ID 2179-211-00-685
GARFIELD COUNTY, COLORADO
Prepared By: Kenneth J. Brotsky, P.E.
558 Rio Oso Lane
Grand Junction, CO 81503
(970) 216-8861
November 15, 2008
I. INTRODUCTION:
This Report has been prepared at the request of Tom Trant,
representative for the above referenced property. This Report
addresses the design of an Individual Sewage Disposal System
(ISDS) for the proposed residence. Public sewer service is not
available.
II. SOILS AND PERCOLATION TEST:
A soils investigation and percolation test was performed by
the Garfield County Building and Sanitation Department on
October 22, 2008. A copy of the percolation test report is
attached hereto. Because of fill in the area of the proposed
absorption field and slow percolation rate, the County required
that the system be designed by a Professional Engineer.
An inspection of the soils was then made by Kenneth J. Brotsky,
PE, on October 31, 2008. The soil profile shows about 18" of
clay, organic fill over 24" of silty clay. The material below
the clay layer is a "maroonesh" hard material (probably a maroon
shale)
There was no standing groundwater and it appears that any high
seasonal groundwater table would be in excess of 8 feet deep.
Average percolation rate for 3 test holes is 101 minutes per
inch. Due to the "maroon" hard layer (shale) beginning at 42
inches below the surface, soil replacement system will be used
in order to provide a minimum of 4 vertical feet between the
bottom of the absorption field and the shale. Existing material
will be removed down to 72 inches (6 feet) and a satisfactory
soil replacement material will be used to a depth of 4 feet.
Soil replacement with a percolation rate faster than 40 minutes
per inch will be used. A percolation rate of 100 minutes per
inch will be used for design.
III. SYSTEM DESIGN:
A. Sewage Flow:
The Owner is intending to add a single bathroom to an existing
shop/barn. An RV will be kept in the barn to use as living
quarters during the interim while a new home is constructed
elsewhere on the property.
The daily sewage flow is calculated as follows:
Average Flow is 1 x 150 = 150 gallons per day
Maximum Flow is 150 x 1.5 = 225 gallons per day
B. Septic Tank
Use 750 gallon tank
C. Absorption Bed:
The absorption bed size is calculated as
follows:
A = 225 x)100 x 1.4
5
630 sq. ft.
Regulations allow a 40% reduction in area with the use of
"INFILTRATOR" units, therefore:
Bed Size required is 630 x .60 = 378 Sq. Ft.
Total Number of units is 378/15.5 = 41 units
Use 4 rows @ 10 units each row = 40 units/O.K.
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KENNETH J. BR
No. 18843
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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
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Owner's Name ( "' U Present Address IRC9<
System Location
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Permit
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Permit: 4 4 /
Assessor's Parcel No.
This does not constitute
a building or use permit.
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Legal Description of Assessor's Parcel No
SYSTEM DESIGN
Septic TaWk Capacity (gallon)
Percolation Rate (minutes/inch)
Required Absorption Area - See Attachedo?
Special Setback Requirements:
Date
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Number of Bedrooms (or other)
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FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
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System Installer
Septic Tank Capacity
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other
Date
Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requinnments of the Colorado State 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-
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 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),
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NOTES
1. Contact Engineer and/or Garfield County Health Department
for inspections at the following times: (Allow at least 24
hours advance notice).
1) When soil replacement and installation of infiltrators,
piping and septic tank is complete
2) When complete
Engineer is Kenneth J. Brotsky (970) 245-3365
Cell (970) 216-8861
2. The sewer line from the house plumbing to the septic tank
and from the septic tank to the absorption bed shall be non-
perforated 4 inch diameter pipe, meeting ASTM Standard D 3034
for PVC sewer pipe, and shall be laid at a minimum slope of 1/8
inch per foot. (1/4 inch per foot is preferred). The pipe shall
be laid so that it will slope continuously down toward the bed
without high points. (If pipe passes under a proposed driveway
use Schedule 40 pipe)
3. INFILTRATOR units to be installed per manufacturers
recommendations. Units to be "Quick -4 Infiltrator" 3' x 4' x
1'. Fasten units together with 2, galvanized self -drilling
screws per unit.
4. The septic tank shall be a 750 gallon, 2 compartment
concrete tank approved by the Garfield County Sanitation
Department.
5. All construction shall be in accordance with "Garfield
County Sanitation Department
6. SOIL REPLACEMENT:
(a.)The existing material down to a depth of 72" below the
surface at the east end of the absorption bed, (14 feet wide by
42 feet long) shall be removed.
(b.) Imported soil replacement shall then be placed within the
excavated area to a depth of 4 feet. The soil replacement shall
be a silty or sandy, clay material with a percolation rate
between 15 and 40 minutes per inch and must be approved by the
Engineer prior to use. The replacement material shall not
contain any rocks exceeding 3 inches in any dimension. The
Infiltrator units shall be placed directly on top of the soil
replacement.
7. Any changes to the layout on these drawings must have the
approval of the Engineer and Garfield County Sanitation
Department prior to construction. Any unauthorized changes may
have to be corrected. Any costs for redrawing of plans
required because of unauthorized changes may be back charged to
the installer.
__ 'TH J. BROTSKY, PE
_JO OSO LANE
GRAND JUNCTION, CO 81507
RECEIVED
DEC 1 4 2009
GARFIELD COUNTY
BUILDING PLANNING
ne^_ember 5, 2009
David meaa
Garfield County Building and Sanitation Department
108 Eighth St., Suite 201
Glenwood Springs, CO 81601
Re: Construction Plan of Record
ISDS Chair Bar Road (Brunson)
Parcel #2179-211-00-685
Garfield County, CO
Dear David;
This is to advise that an inspection was made during construction
of the above referenced ISDS and that the system has been
constructed essentially in accordance with the approved Plans anct
Specifications, and as shown on the attached "Construction Plan
of Record". A poly vinyl septic tank was used.
Ties from the shop corners to the tank and the bed distribution
box are shown on the attached "Construction Plan of Record".
Sincerely yours,
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