HomeMy WebLinkAbout03568U(- P.
• �. GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit NS 3568
109 8th Street Suite 3Q3 - - Assessor's Parcel No.
{ Glenwood Springs, Colorado 81601
g Phone (303) 945-8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
i -
PROPERTY Uwe �p / Q� y�1 b �/�.
r Owner's Name u I`` ' ` (acee. bAR lof.�LLC.
L snt Address �'� ` �z ' 1 K `S �/4d Phone 3 ��/-aB
i
System Location 6G 4'`ea C+. CcK165a-
I'a keko 0cos Bo�e(oe .
f Legal Description of Assessor's Parcel No.
, t
SYSTEM DESIGN
i
Septic Tank Capacity (gallon)
Percolation Rate (minutes/inch)
S
Required Absorption Area - See Attached
{
`Special Setback Requirements:
i
Other E'y
Number of Bedrooms (or other)
r Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
F
System Installer
Septic Tank
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
Other
Date J_1b15L� Inspector
RETAIN WITH RECEIP
*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, orinstallsan Individual sewage disposal system in a mannerwhich involvesa 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
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER Ut1�1� i� t� >� �� to �, a # L L c
ADDRESS 01 1112 QUev010A '-(�1 g1b�Z PHONE�3�4-Z43�1�1
CONTRACTOR IL,pw �QKi d wa+ J a 1r< .
ADDRESS PO SO -f 11 �-1 ��+ f �oo�! l f-� PHONE
PERMIT REQUEST FOR 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).
Nty hat Cit of
6 f 4iq �2. a►a-<-)
Legal Description or Address to{ 2 Uk.41e Q Y C+y CO
WASTES TYPE:
BUILDING OR SERVICE
(X) DWELLING
( ) COMMERCIAL OR INDUSTRIAL
( ) OTHER - DESCRIBE
) TRANSIENT USE
( ) NON-DOMESTIC WASTES
Number of Bedrooms L+ Number of Persons
( ) Garbage Grinder ()o Automatic Washer (yQ Dishwasher
Sol mrF AND TYPE OF WATER SUPPLY -V) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:_Vuit
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System? "o
A§ite Dian Is regulred to be submitted that indicates the following MINIMUM distances:
Leach Field to Well: 100 feet
Septic Tank to Well: SO feet
Leacls Field to Irrigation Ditcbea, Stream or Water Course: 50 feet
Septic System to Property Linea: 10 feet
^*"" :"'^.""UAL SEWAGE DISPOSAL SYSTEM PERI►IIT WE L NOT BE ISSUED WITHOUT
A SITE PLAN,
GROUND CONDITIONL
Depth to first Ground Water Table
Percent Ground Slope
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
( )
UNDERGROUND DISPERSAL
(
)
SAND FILTER
( )
ABOVE GROUND DISPERSAL
(
)
WASTEWATER POND
( )
OTHER - DESCRIBE
WILL
EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS
OF
THE STATE? Flo
PERCOLATION
TEST RESULTS; (To be completed by Registered Professional
Engineer, if the Engineer does the
Percolation Test)
Minutes per inch in hole No. I Minutes
oer 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:
UI
G eol e4i — / qqi
Name, address and telephone of RPE responsible for design of the system: e. K a, 6 E� ibw,kt
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
fi l0cation 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 Date g/ 6 /0 /
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTYI I
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Witness Corner
October 31, 2001
Garfield County Building & Planning
109 Eighth Street, Third Floor
Glenwood Springs, CO 81601
Re: ISDS for Lots 1,2,3,7 and 9 —Ukele Acres Subdivision
HCE Job No. 2011081.59
To Whom It May Concern:
RECEIVED ROY 0 7 2001
On October 8, 2001, High Country Engineering personnel observed the construction of the ISDS
Lots 1,2,3,7 and 9 of the Ukele Acres Subdivision in Garfield County, Colorado. The observations
made were:
Lot 1
The tank had been buried, but it appeared that one 1000 -gallon septic tank had been installed
with 24 standard Infiltrator units in a trench configuration. No additional backfilling had
taken place. The owner was advised to rake the trench sidewalls, install the effluent filter and
install the inspection wells. Other than that, the installation of the system was in
conformance with the intent of the design.
ZLot 2
e 1000 -gallon septic tank and 34 standard Infiltrator units had been installed in a trench
configuration. No backfilling had taken place. The owner was advised to rake the trench
sidewalls, install the effluent filter and install the inspection wells. Other than that, the
installation of the system was in conformance with the intent of the design.
Lot 3
One 1000 -gallon septic tank and 112 standard Infiltrator units had bcc:. installed in a bed
configuration. No backfilling had taken place. The owner was advised to rake the bed
sidewalls, extend the outlet tee into the center of the septic tank riser, install the effluent filter
and install the inspection wells. Other than that, the installation of the system was in
conformance with the intent of the design.
Lot 7
One 1000 -gallon septic tank and 32 standard Infiltrator units had been installed in a trench
configuration. No backfilling had taken place. The owner was advised to rake the trench
sidewalls, install the inlet tee in a vertical position, install the effluent filter and install the
inspection wells. Other than that, the installation of the system was in conformance with the
intent of the design.
1517 Blake Avenue, Ste. 101 14 Inverness Drive East Suite B,144
Glenwood Springs, CO 81601 Englewood, CO 80112
Telephone (970) 945-8676 - Fax (970) 945.2555 Telephone (303) 925-0544 - Fax (303) 925-0547
Garfield County Building & Planning
October 31, 2001
Page 2
Lot 9
One 1000 -gallon septic tank and 26 standard Infiltrator units had been installed in a trench
configuration. No backfilling had taken place. The owner was advised to rake the trench
sidewalls, install the effluent filter and install the inspection wells. Other than that, the
installation of the system was in conformance with the intent of the design.
A follow up inspection was conducted on October 30, 2001. At the time of re -inspection, all
inspection wells had been installed and septic tanks had been covered.
If you have any questions, or need additional information, please contact us.
Sincerely,
HIGH COUNTRY ENGINEERING, INC.
). Neal, P.E.
Manager
RDN/djw
Cc: Pete Waller
'�E
29V5
�rCO
1517 BW¢ Avenue, Ste. 101 14 Inverness; Drive East Suite B-144
Glenwood Springs, CO 81601 Englewood, CG 80112
Telephone (970) 9458676 - Fax (970) 935-2555 Telephone (303) 925 -OW - Fax (303) 925-0547