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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 9454212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit 4141
Assessor's Parcel No.
This does not constitute
a building or use permit.
Owner's Name 1 q it RP rl ' Present Address5_3(f 1 C 1 C5b C Alga
System Location r �3 % / dr
9 l )L // C /C
o C ' `�' ?
Legal Description of Assessor's Parcel No x`3`!3 ` as/- 00 -
SYSTEM DESIGN
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms
(or other)
v.
tw4--
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
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
V-2-06
Inspector
/2/ r�rCI. eat.. Der i c, wailer P.f.
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE10- 3y//Q
*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 1, Petty Offense ($500.00 fine — 6
months in jail or both).
WA• A 015 Ir ADr v 11 . .nut
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER 0.6)/i /J_��/""vl� -//er / `
ADDRESS 3'34 COUtIk «0 /Oa ( atb- PHONE q63'ge6Z
CONTRACTOR 0(04 et
ADDRESS PHONE
PERMIT REQUEST FOR ( ) NEW INSTALLATION ( ) ALTERATION (X) 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 FACILITY: /j
ea
53'/9 coumiti ed • /aa
Near what City of Town
Legal Description or Address
WASTES TYPE:
Size of Lot a'2 �C S •
(4 DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER—DESCRIBE
BUILDING OR SERVICE TYPE: 51 ✓iL9
Number of Bedrooms Number of Persons
( ) Garbage Grinder ( ) Automatic Washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: �J
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: / 4/0-6'S
Was an effort made to connect to the Community System? % 0
A site plan is required 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 (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 V,26
Percent Ground Slope
2
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(7() SEPTIC TANK
( ) VAULT PRIVY
( ) PIT PRIVY
AERATION PLANT
COMPOSTING TOILET
INCINERATION TOILET
VAULT
RECYCLING, POTABLE USE
RECYCLING, OTHER USE
( ) CHEMICAL TOILET( ) OTHER -DESCRIBE
FINAL DISPOSAL BY:
()c) 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? No
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 of RPE who made soil absorption tests:
Name, address and telephone of RPE 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.
Signed
PLEASE D
EA. Date
TE MAP TO YOUR PROPERTY!!
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County Road (Note the Road Number and Name)
RESULTS OF PERCOLATION TEST
ADDRESS DESCRIPTION 531/9C'/00 C o, c.
a�JJ /
DEPTH AND DIAMETER OF HOLE #1 _1" @ 0 #2 "
APPROX. GALS. ADDED HOLE /J1 C. HOLE #2 G
TEST HOLES WERE PRE—SOAKED FROM: (Date)/b (Time) 3 p • r M
HOLE #1
TIME REF MARK
TO H2O
/5m;e,
1/Y
FALL
/5
0,
/5
0. /15
Llo
RATE
/9
32
3B
TIME
HOLE #2
REF MARK
TO H2O
/5
0.110
/5
FALL
0.50
0,q5
0,110
RATEI
BUI PROJECT f 11�'`'"2 ' C3
DATE) —3_6(
n p3
HOLE #3 _S2__
TO: (Date) 3..f fD(a_ (Time) t&Q___
TIME
/5
HOLE #3
REF MARK
TO 1120
11
FALL
0,65
MPI
RATE
2.9
/5
0,vo
yo
/5.
15
0, 35
0,30
630
60
AVERAGE PERCOLATION RATE: Li? MPI
REMARKS•topography, ambient/soil/water temperatures,
insulation on site, weather, vegetation, site description)
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PROFILE HOLE
AND SOIL DESCRIPTION
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BY
Boundaries Unlimited, Inc.
923 Cooper Avenue, Ste. 102
Glenwood Springs, CO 81601
tele: 970.945.5252 fax: 970.384.2833
SCALE 1”=-
DATE:
"=DATE:
FILE:
SHEET
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Darfield County. Colorado
Myler ISDS
Individual Sewage Disposal System
System Replacement
Dave Myler
5349 CR 100
Carbondale, Colorado
Sopndarues DES: dw NO DATE
-y.._ Unlimitecl, Inc D : dw
Consulting Engineers CN: pall
923 Grope 800009, sin 10 DATE. 3[006
0M rood5pn 90 0081801
SW 970 94532521 ¢ 970386 2833
REVISION
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Myler ISDS
Individual Sewage Disposal System
System Replacement
Dave Myler
5349 CR 100
Carbondale, Colorado
6owtIdarlesDES: dl•
Unlimited Inc DR dl.
Glenwood Springs, CO 81601
NO
DATE
REVISION
BY
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923 Cooper Avenue, Sle 10 DATE. 3/8/06
rae 970 94E5252 ler 970 3e4.2e33
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Effluent Pumping System - Dual Compartment Drawdown
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00 0
Garfield County. Colorado
Myler ISDS
Individual Sewage Disposal System
System Replacement
Dave Myler
5349 CR 100
Carbondale, Colorado
6owtIdarlesDES: dl•
Unlimited Inc DR dl.
Glenwood Springs, CO 81601
NO
DATE
REVISION
BY
Consulting sown Engineer. CR: pan
923 Cooper Avenue, Sle 10 DATE. 3/8/06
rae 970 94E5252 ler 970 3e4.2e33
BOUNDARIES
..._.. UNLIMITED INC.
Civil & Consulting Engineers
April 7, 2006
Garfield County Building & Planning
Attn: Fred Jarman
108 8th Street, Ste. 201
Glenwood Springs, CO 81601
Re: ISDS for 5349 County Road 100, Carbondale, Colorado
BUI Project: 06002.03 (Myler)
To Whom It May Concern:
-00# laeA4mAl
—Vitt( "Ar
On March 17, 2006, Boundaries Unlimited Inc. personnel observed the construction of
the ISDS for 5349 County Road 100 in Garfield County, Colorado. A new 1000 -gallon
septic tank was installed in series with the existing 1000 -gallon septic tank and 78 Quick
4 Infiltrator units had been installed in a bed configuration. No backfilling had taken
place. The contractor was advised to install the inspection ports where indicated on the
plan and to continue with the installation of the effluent pump. Other than that, the
system was installed in conformance with the intent of the design. If you have any
questions, or need additional information, please feel free to contact me at 945-5252.
Sincerely,
BOUNDARIES UNLIMI bla;/S
•
.,,oN. Tf9 i
Its �i'TOLmo
17110 73i
Deric J. Walter, P.E. '
Project Manager
Cc: David Myler
RECEIVED
APR 1 2 2006
GAR& tiiu COUNTY
BUILDING & PLANNING
823 Blake Avenue [ Suite 102 Glenwood Springs [ Colorado 81601 Ph: 970.945.5252 Fax: 970.384.2833