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• • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N~ f 3573
Assessor's Parcel No. < 109 8th Street Suite 303
'enwood Springs, Colorado 81601
· · . Phone (303) 945·8212
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.. J INDIVIDUAL SEWAGE DISPOSAL PERMIT I PROPERTY
This does not constitute
a building or use permit.
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J Owner's Name l/Kele acf(e.s Del!t1t(J<f'l.?.fiAddress Jl/ri{)Jtl/-t. Ave G ., <g/~1>/Phone
.. ! System Location Q { { 0 €srliM yf • Sj /f G, J>/~J). .
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't Legal Description of Assessor's Parcel No. i!otrz like le a Cl{es ..
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SYSTEM DESIGN
_____ Septic Tank Capacity (gallon) ------•Other
______ Percolation Rate (minutes/inch) Number of Bedrooms (or other) ____ _
Required Absorption Area -See Attached
Special Sbtback Requirements: \.._
Date _____________ Inspector ___________________________ _
FINAL SYSTEM INSPECTION AND APPROVAL (as Installed)
Call for Inspection (24 hours notice) Before Covering Installation
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 _____________________ _
Date /bj'6/ot
•CONDITIONS:
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I ,, 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.
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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).
Whtte. APPLICANT Yellow. DEPARTMENT
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INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER V\\,;_,~_A0c.<;. Q~v"<.--\of"""'·,,__:1-,Ll.C.
ADDRESS B:? '\30-1 '11.1 £3,l-tv 11109 J Sf& 51i:, o<..
CONTRACTOR Jl 1 ovv. l.A-u.( ·'> ._,,) W oJ \ ~ \ "' < •
ADDRESS Po !So-> 111..1 s1~_V'vJooJ'Cfs.~
PERMITREQUESTFOR ~ NEWINSTALLATION ( )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 FACOJTY;
Near what City of Town <;; \ +-'f Size ofI.ot f "2.!•-1, 7.olf-{ .(.~:)
Legal Description or Address Lot 7 uv. ... 1~. A<n~ c ... ~J,;-J;C :.,..,..,, I Gu.rf·dJ (-1'1. Co
wAsTEs rYPE: (')(.) DWELLING Es~e.,~ Ct · < > TRANSIENT usE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( )OTHER-DESCRIBE,,--~-------·----~-
BUILDING OR SERVICE TYPE: mQ!f\u-( t& rh£
Number of Bedrooms_ q Number of Persons __ 5(,__ ___ _
( ) Garbage Grinder cy> Automatic Washer (X) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ()() WEU, ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: U'u. le_ A:~-r~ (6-<"'rv-v.:. ~-y Wc4--<r
DIST ANCE TO NEAREST COMMUNITY SEWER SYSTEM: ~;\ r ----=-.:...;_-------~
Was an effort made to connect to the Community System? ___ t-....;;J:...L> ___________ _
a site plan la reqalred to be spbmltted that tndlcates fl1e following MINIMUM dlstapces;
Leach Field to Well; 100 fcet
Sepdc Tank to Well; 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septk System to Property Lines; 10 feet
YQUB INDNIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SIIEfLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table ______________________ _
Percent Ground Slope __________________________ _
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TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
()G SEPTIC TANK ( ) AERATION PLANT ( ) VAULT
( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE
( ) CHEMICAL TOll..ET ( ) OTHER -DESCRIBE
FINAL DISPOSAL BY:
()() ABSORPTION TRENCH, BED OR PIT ( ) EV APOTRANSPlRATION
( ) UNDERGROUND DISPERSAL ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER -DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? -~.._o.__ ___ _
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 ofRPE who made soil absorption tests: f}f 6R.o{-e l.h · ! q 9 5
Name, address and telephone ofRPE responsible for design of the system: J')?S&{<-(±J(:Jla C'.*'t (-: •ll3{&¥iJ
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and
additional teats 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 pennit 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
tilsification 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.
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
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. t5' UTILITY .
1EASEMENT
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October 31, 200 I
Garfield County Building & Planning
I 09 Eighth Street, Third Floor
Glenwood Springs, CO 81601
Re: ISDS for Lots 1,2,3, 7 and 9 -Ukele Acres Subdivision
HCEJob No. 2011081.59
To Whom It May Concern:
RE€El\IEO ~OV O 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 eftluent filter l!Ild
install the inspection wells. Other than that, the installation of the system was in
conformance with the intent of the design.
Lot2
One 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 effiuent filter and install the inspection wells. Other than that, the
installation of the system was in conformance with the intent of the design.
Lot3
One l 000-gal!on septic tank and 112 standard Infiltrator units had bee:; installed i.,, 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 effiuent filter
and install the inspection wells. Other than that, the installation of the system was in
conformance with the intent of the design.
fr:.";)
~000-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 effiuent filter and install the
inspection wells. Other than that, the installation of the system was in conformance with the
intent of the design. ·
1517 Blalle A""1ue. Ste. IOI
Glenwood Sprinss, CO 81601
Telephone (970) 94S-8676 • Fax (970) 94S·2SSS
14 lnvcmcss on .. East SuitcB.144
Englewood, co 80112
Telephone (303) 92S-OS44 • Fax (303) 92S-OS47
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-. Garfield County Building & Planning
October 31, 2001
Page2
Lot9
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,
RDN/djw
Cc: Pete Waller
1517 Blake Avenie, Ste. 101
Glenwood Springs, CO 81601
Telephone (!170) 945-8676 -Fax (970) 945-2555
14 lnvemess Drive East Suite 8--144
~ood.0080112
Telephone (303) 925-0544 -Fax (303) 925-0547