HomeMy WebLinkAbout03636' I
t
I
l
I
I
j
•' I
I
I
I
!
\
I
;
I
I
I
!
---------------------------·;.. , ~/;;1/0;. ~,1/so.6b-~£F·
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945·8212
I\!" Permit p, ;_ 363F
Assessor's Parcel No.
INDIVIDUAL SEWAGE DISPOSAL PERMIT
) PROPERTY
This does not constitute
a building or use permit.
t Owner's NameA~(Y\sfiQ°"j 1 C. I iz •
System Location I \ \ Y C {)... I 3fl
Present Address 1114 CR I ?/l G .S,Q, ~/bO/Phoneq ~( S' -,}<(Sj
c.::: ' s . <? l l,, {.) (
• Legal Description of Assessor's Parcel No.-----------------------------------
:·.
< SYSTEM DESIGN
______ Septic Tank Capacity (gallon) ______ ,Other
----C..--Percolation Rate (minutes/inch) Number of Bedrooms (or other) ____ _
Required Absorption Area -See Attached
Special Setback Requirements:
lZJJr..1>/.f..f{).Ff) S'.,.~~ 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 _____________________ _
Other----------------------------~------~--------
Date ___________ lnspector f.b.4£'°4 /;r. ~ II( kk
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 4-}2 -0 /
'
'·
•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.RS. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con8
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
•
I
!
\
"
•
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER l i !\<; "'' S -f < ('',
ADDRESS 1114 C,t. Rd· 137 I G, s PHONE °l cf§· J-l(5 'J
CONTRACTOR 'Dnl\~~ C.reel~ Lo'( tlu"""-e s
ADDRESS s1q 1J fl,,,f· 3 1/e I Olc.+he ('c, 81'./7..) PHONE 7...t/o -I e, '7 ~
PERMITREQUESTFOR (V) 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 PRQPOSED FACILITY:
Near what City of Town Gl('" wood. Spr •"'q) Size ofLot 56 "-<-t~-'
Legal Description or Address _11 _1 '~i ~('~21~·,1 .... , ~'R.=ci.~~'~3~7'--_0_,~l '~' '~'"-'"'=:.x~:>~d_S=fpc~;~"'"''li-'~-------
WASTES TYPE: ('-?DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER-DESCRIBE. _______________ ~
BUILDING OR SERVICE TYPE:_«~e=-;~; d,._~"'-=-'-~'-'c_I ------------------
Number of Bedrooms 3 Number of Persons ----"2.."'"-----
( ) Garbage Grinder ( '1 Automatic Washer
SOURCE AND TYPE OF WATER SUPPLY: ( 0 WELL
( '1' Dishwasher
( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: ________________ _
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Cq "''l°'' C r·c<> K
Was an effort made to connect to the Community System?~~o~-------------
A site plan ls reguirecl to be submitted that Indicates the following MINIMUM distances:
Leach Field to Well: 100 feet
Septic Tank to Well: 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System to Property Lines: 10 feet
YQUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GRQUND CONDITIONS:
Depth to first Ground Water Table _______________________ _
Percent Ground Slope. ___________________________ _
2
- - - - - - - - - -----------------• . '
TyPE Qt< INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( t-1' 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:
( vY ABSORPTION TRENCH, BED OR PIT ( ) EV APOTRANSPIRATION
( ) UNDERGROUND DISPERSAL ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER-DESCRIBE --
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?
PERCOLATION TEST RESULIS: (To be completed by Registered Professional Engineer, ifthe Engineer does the
Percolation Test)
Minutes er inch in hole No. 1 ----~ Minutes _____ _,.er inch in hole NO. 3
Minutes er inch in hole No. 2 Minutes er inch in hole NO.
Name, address and telephone ofRPE who made soil absorption tests: ______________ _
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 pennit is
subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made,
information and reports slibmitted 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 pennit applied for herein. I further understand that any
falsification or misrepresentation may result in the denial of the application or revocation of any pennit granted based
upon said application and in legal action for perjury as provided by law.
Signed ~ Or""~_j. ~ ... j:k Date_-"-0-'-I _. _,l"'~----"O"--<..=------
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
-;,..:"-_;;.o,_~
'
Designate North Arrow 1
Your Neighbor's
Name & Address
~ \\ -1-o h.,~
\tJ. s,·~e. to "o'lS
f . s ; ".q_ fl> h<>I.\
t0. s i&~:+o pror.
Le.:1.ch -Be I& :/6'0
~l\I<. So'
I
I
-!
' I
I/cm'
IJ..~'+
\
Your Plot -Shape to Fit
(No Scale)
. ~ <:,,,, '\""' 0-e.. v
1'l~f""'· \'Z.S'
s e.?t1.:. 5 ~) "'°'"'"' ; S« c.-1-W.
Locate well, all streams, irrigation ditchs, 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, before a
Certificate of Occupation will be issued.
County Road (Note the Road Number and Name)
{3AJ
·\.
Your Neighbor's
Name & Address
pv,\\oc.. \<. sr.
. .
•
RECEIVED JUN O ., 2002 ..
April 22, 2001
Garfield County Building & Planning
I 09 Eighth Street, Third Floor
Glenwood Springs, CO 81601
Re: Armstrong ISDS -HCE No.99644.03
114 County Road 137
To Whom It May Concern:
On April IO, 2002, High Country Engineering (HCE) personnel inspected the construction of the
ISDS located at 114 CR 137 in Garfield County, Colorado. HCE's design calls for Sx9 bed with 45
infiltrator units. The bed area has been over excavated 4' and backfilled with 6" minus pit run. PVC
liner is installed on the downhill side if the bed along the bed wall. (1) 1000 Gal. Septic tank is
installed and all piping from the house to the tank and from the tank to the infiltrator units is
insulated with 2" of blue board. At the time of inspection, the contractor had constructed this system
and installed a 1000-gallon concrete septic tank and the required chamber units. No backfilling had
taken place. Field personnel observed that the depth of the trenches with gravel did not necessitate
ventilation and advised the contractor to install standard inspection wells. Otherwise, the
installation of the system was in conformance with the intent of the design.
If you have any questions, or need additional information, please contact us.
Sincerely,
HIGH COUNTRY ENGINEERING, INC. .
.• ~ ,';, • '»S'<,
~;;,;'"~li llEGi'~-> ,• ~:· .,~.~ .... " ......... 0 /'..;. {) \
t ' ··,Y •• •0 1:.P. D. "'•, ''8, 'Ji
·j '-Jr~ "'<"Ci • Cf;;;,,; "o ""' ··. '<c' }
Roger D. Neal ' , g ~ i . I \ '
Project Engineer 2H • " f . · .~~·.. lti1
RDN/ ·~··.. ....,~ cmt (C"-8 ·· ............ ··-....\v
• 8IONAL ~\
•. ~"'>:! Cc: Elizabeth Armstrong
923 Cooper Avenue,
Glenwood Springs, CO 81601
Telephone (970)945-8676 ·Fax (970) 945-2555
14 lnvemess Drive Easl Suite B-144
Englewood, CO 80112
Telephone (303) 925-0544 ·Fax (303) 925.()547