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Home My WebLink About03771t ' GARFIELD COUNTY LDING AND SANITATION DEPARTMENT 109 8th Streat Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945·8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Nam:5e5'51~/?a:st= Permit N~ 3771 Assessor's Parcel No. This does not constitute a building or use permit. System Location_.+~,,t__),.~-\___.:~*'U."')~'-'~...L.S!>"'j~M..~-<-jl.-..J!L..-:o~"-,,,--~...11~u£...:.ll.;==~=-,--- SYSTEM DESIGN ______ Septic Tank Capacity (gallon) -----~Other ______ Percolation Rate (minutes/inch) Number of Bedrooms (or other) ____ _ Required Absorption Area -See Attached Special Setback Requirements: Date .5e..p/ j 2 -Zoo 2 FINAL SYSTEM INSPECTION AND APPROVAL (as inst lied) Call for Inspection (24 hours notice) Before Covering In allation System Installer _____________ __,>--------------------------- Septic Tank Capacity ____________ --\-------------------------- Septic Tank Manufacturer or Trade Name ------+--------------------------- Septic Tank Access within 8" of surface --------\-------------------------- Absorption Area ----------------4----------------------- Date _____________ lnspector _______ _,.L._ __________________ _ 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 vahd 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 Bu1ld1ng 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 1nd1v1dual sewage disposal system in a manner which involves a knowing and material variation from the terms or specifications contained in the apphcat1on of permit commits a Class I, Petty Offense ($500.00 fine - 6 months 1n jail or both). White -APPLICANT Yellow -DEPARTMENT . ' INDMDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER 'Po:t 'S?ss1c'i'\'$ ADDRESS tJ?CI ~$~~.Ml~ R. 33(33, PHONE(30'S) St(p-03<'.,'1 CONTRACTOR le-u.:f10 (pn&t. I'l\c... ADDRESS 12s ~<-jd D<\..ic:J •, °°"~'Yk.~o (o PHONE CJ'<o3-z.<:::oa PERMIT REQUEST FOR t>6 NEW INSTALLATION ( ) ALTERATION ( )REPAIR Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitahle building, location of potahle water wells, soil percolation test holes, soil profiles in test holes (See page 4). LOCATION OF PROPOSED FACILITY: WASTES TYPE: ( ) OTHER-DESCRIBE _______________ _ BUILDING OR SERVICE TYPE: S\ "'@i\Q fu.M.-, \'{ fus~ocU Number of Bedrooms Number of Persons. __ 4-..__ __ _ ()'Q Garbage Grinder (~Automatic Washer (/'f Dishwasher SOURCE AND TYPE OF WATER SUPPLY: Oc:j WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Sf?&a Vaj~ Was an effort made to connect to the Community System? -~N~C~---------- A site plan is required to be submitted that indicates the followin& MINIMUM distances: Leach Field to Well: 100 feet Septic Tank to Well: SO feet Leach Field to Irrigation Ditches, Stream or Water Course: SO feet Septic System (septic tank & disposal field) to Property Lines: 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN. GROUND CONDITIONS: Depth to first Ground Water Table ______________________ _ Percent Ground Slope __________________________ _ 2 r \ ... TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: IX> 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: 0() 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 RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the PercolationTest) ~Ci\'dli".'"4 "C~ l'S. "kfr Minutes er inch in hole No. 1 Minutes -~'-"P .... o __ _,,per inch in hole No. 3 Minutes_.+-1~--P"' Minutes'----~-_,.er inch in hole No. UP Ge eie c.b. Name, address and telephone ofRPE responsible for design of the system:---------- 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 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 perjury as provided by law. Sign~~k~~-Date 9-l~-ov PLEASE WAN ACCURATE MAP TO YOUR PROPERTY!! 3 ·~ -·-..• CHURCH & Associates, Inc. September 22, 2003 JeffLewin Construction Attn: JeffLewin 425 Boyd Drive Carbondale, Colorado 81623 ENGINEERS & GEOLOGISTS Subject: Installation Observation,. ProposedResidence Parcel 15, High Aspen Ranch Garlield County, Colorado Job No. 15496 Mr. Lewin, As requested, we observed the installation of the onsite wastewater system (OWS) for the subject site on September 5, 2003. The system was designed for a four-bedroom residence under our Job No. 15496, and presented in a report dated January 15, 2003. The system includes the installation of a 1500-gallon,. two-comp~ precastconcreteseptic tank with a Biotube™ pump vault in the second compartment. A 4800 ft2, shallow trench, drip-irrigation drain field was installed in four 8-foot by 100-foot sections . . The pump and effluent filter were in place at the time of our site visit. Final electrical connections must be completed by a licensed electrician. The remaining observed components of the OWS were installed in general conformance with our design. Our installation observations do not imply a guarantee or warranty of materials or workmanship. If there are questions, please call. CHURCH & Associates, Inc. Timothy R Petz EOC/trp 2 Copies sent Copy and FAX to Garfield Health Department,. Attn: Tim Holiday DENVER 4501 Wadsworth Boulevard Wheat Ridge, CO 80033 303.463.9317 Fax: 303.463.9321 www.geo-church.com Toll Fres-1.an.248.3123 • • ± 30.1 ACRES PARCEL 15, HIGH ASPEN RANCH GARFIELD COUNTY, COLORADO 4800 F OF DRIP IRRLTION DRAIN I D IN SIX 8')060' SEC IONS / / / J lo PROPO.se£ ~ ( / OD-GALLON, T~COMPART T, / PRE CAST CONCRETE SEPT TANK / / WITH A)lr6TUBE® PU AULT IN / THE J>fCOND COMP TMENT. / ;(,_<!s> / 4i"' CLEANou/------ ( OBSERV~IION/ VENT PIPf=S I ) / / / / OWS AS-BUil T DRAWING JOB NO .15496W -y~ /VALVES SCALE 1" = 50' / FIGURE 2