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' GAR ` LD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 3 9 5 0
Assessor's Parcel No.
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
This does not constitute
a building or use permit.
,��
Owner's Name' 111 9 Present Addr=war; !lw8_`�r
System Location \ �f ak 1 •
�)III51
Legal Description of Assessor's Parcel Nal 37 -3.51 -Co -01
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
12-444 I is-f-1-440
criA
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
Inspector t I / ' .4
RETAIN WITH RECEIPT RECORDS AT CONSTRUC°e
N 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 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).
White - APPLICANT Yellow - DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER ACA cc f (,(JUUan
ADDRESS O.S—
CONTRACTOR S-, G O 1 1
ADDRESS 1 O 1 CrAe-r CJctvt ICS0.So..lt'• PHONE 5'27-9//v
PHONE 927-3 )'
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).
LOCATION OF PROPOSED FACILITY:
Near what City of Town i 9,rban d C
Legal Description or Address 1--. off- 'O \-luw c rc c� Co.b
Si e f Lot C_) 1 . i AL'r'c.j
1:5 5
e.n I (bon et 1
) TRANSIENT USE
NON-DOMESTIC WASTES
WASTES TYPE: p,4 DWELLING
( ) COMMERCIAL OR INDUSTRIAL (
( ) OTHER -DESCRIBE
BUILDING OR SERVICE TYPE: &St cue C c.
Number of Bedrooms Number of Persons 2 \u
() Garbage Grinder ( ) Automatic Washer (1 ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: t 5 >r, a v.,,1,
Was an effort made to connect to the Community System? N v
A site plan is required to be submitted that indicates the following MINIMUM distances:
Leach Field to Well:
Septic Tank to Well:
Leach Field to Irrigation Ditches, Stream or Water Course:
Septic System (septic tank & disposal field) to Property Lines:
100 feet
50 feet
50 feet
10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table
2 V �ccc.r
Percent Ground Slope //ase ye it r 71-v ADA 6," i- y ; int e
/7ro.c)0-SiO i•00
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?4h)
PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the
Percolation Test)
Minutes 30 per inch in hole No. 1 Minutes 2 (i per inch in hole No. 3
Minutes 1 Ss per inch in hole No. 2 Minutes 1 cc per inch in hole No. %
Name, address and telephone of RPE who made soil absorption tests:
Name a1idreqs and telephone of RPE esponsible for design of the system: lt c/3— C [ Y C
`ac (� � siyne� sljs+e n
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 �/ j�% int: S iq • Dat9%yO fr /d V
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!/
GGUTeCh
HEPWORTH -PAWLAK GEOTECHNICAL
June 30, 2003
Mike Weldon
P.O. Box 2425
Basalt, Colorado 81621
Hepworth-Pawlak Geotechnical, Inc.
5020 County Road 154
Glenwood Springs, Colorado 81601
Phone: 970-945-7988
Fax: 970-945-8454
email: hpgeoChpgeotech.com
Job No. 103 366
Subject: Additional Percolation Testing, Parcel 10, Homestead Subdivision,
Garfield County, Colorado
Dear Mr. Weldon:
As requested by you, Hepworth - Pawlak Geotechnical, Inc., performed additional
percolation testing at the subject site. The work was done in addition to our agreement
for Professional Services to you, dated June 4, 2003. We previously provided a
subsoil study for foundation design and percolation testing at the subject site and
reported our findings June 20, 2003, Job Number 103 366.
Two Profile Pits and seven percolation test holes were excavated on June 26, 2003 at
the locations shown on Fig. 1. The tested area was south and downhill of the previous
test site and located in a broad shallow valley. The subsoils exposed in the Profile Pit
consisted of about 6 inches of topsoil overlying t to 2 feet of sandy clay. Basalt
boulders and cobbles in a sandy matrix clay were encountered below the sandy clay to
the bottom of the pits at 5 to 6 feet where refusal to the backhoe was encountered on
basalt boulders. No free water was observed in the pits and the soils were slightly
moist to moist. Percolation test holes were hand dug in the bottom of shallow backhoe
pits and presoaked with water on June 26, 2003.
Percolation testing was conducted on June 27, 2003, by a representative of Hepworth -
Pawlak Geotechnical, Inc. The percolation test results varied from 18 to 90 minutes per
inch and are summarized on Table I. The overall average percolation rate of the seven
tests was 38 minutes per inch. Based on the subsurface conditions encountered and the
percolation test results, the tested area should be suitable for a conventional infiltration
septic disposal system. The septic disposal system should also be located and graded to
reduce surface water runoff infiltration.
HEPWORTH-PAWLAK GEOTECHNICAL, INC.
TABLE 1
PERCOLATION TEST RESULTS
PAGE 1 of 2
JOB NO. 103 366
HOLE N0.
HOLE DEPTH
(INCHES)
LENGTH OF
INTERVAL
(MIN)
WATER DEPTH
AT START OF
INTERVAL
(INCHES)
WATER DEPTH
AT END OF
INTERVAL
(INCHES)
DROP IN
WATER
LEVEL
(INCHES/
AVERAGE
PERCOLATION
RATE
(MIN./INCH)
P-4
37
15
water added
6 1/2
5 1/2
1
30
5 1/2
4 3/4
3/4
6
5 1/4
3/4
5 1/4
4 3/4
1/2
4 3/4
4 1/4
1/2
4 1/4
3 3/4
1/2
P-5
40
15
water added
8
61/2
11/2
18
6 1/2
5 1/2
1
8
7
1
7
6 1/4
3/4
6 1/4
5 1/4
1
5 1/4
4 1/2
3/4
P-6
34 -
15
water added
71/2
6
1 1/2
26
6
5 1/4
3/4
6 1/4
5 1/4
1
5 1/4
4 3/4
1/2
4 3/4
4
3/4
4
3 112
1/2
ihr
CIVIL ENGINEERING
April 28, 2005
Andy Schaller
Garfield County Building and Planning
108 8th Street, Suite 201
Glenwood Springs, CO 81601
M Employee -Owned Company
Re: Mike Weldon ISDS — Lot 10 Homestead Subdivision
HCE Project Number 2031031.00 x 0218
Dear Andy:
LAND SURVEYING
RECEIVED
MAY 0 2 2005
GARFIELD COUNTY
BUILDING & PLANNING
The following letter is to confine the engineer's inspection of the septic system of the Weldon
Residence at Lot 10 Homestead Subdivision. High Country Engineering's field inspector
performed the field inspections. The asbuilt ISDS is per plan, which is composed of a 1,250 -gallon
septic tank, 29 infiltrator units, cleanouts, effluent filter, inspection wells and benn. Blueboard (2 -
inch x 24 -inch) was installed above the house line from inlet side of septic tank for approximately
30 -feet towards the cleanout at the house since the line is shallow. The system was built according
to plans.
If you have any questions, or need additional information, please contact us.
Sincerely,
HIGH COUNTRY ENGINE
1517 Blake Avenue, Suite 101
Glenwood Springs, CO 81601
970.945.8676 phone
970.945.2555 fax
www.hceng.com
14 Inverness Drive East, Suite F-120
Englewood, CO 80112
303.925.0544 phone
303.925.0547 fax
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!XRING, INC.
ENGLEWOOD, CO 80112
(303) 9250547
100D SPRINGS, CO 611301
(970) 9452555
14
DRAWN BY.
DRD
CHECKED BY:
RDN
DATE:
428-05
FEE.
ISDS-ASBUILT
NO. DATE
REVISION
BY
CENTERCALL OF NOTIFICATION
1.800-922-1987
OR 534-06700 IN METRO DENVER
CALL 2BUSINESSS DAYS IN ADVANCE
BEFORE YOU DIG GRADE, OR
EXCAVATE FOR THE MARKING OF
UNDERGROUND MEMBER U'TILlnES
GRAPHIC SC
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MIKE WELDON
GARFIELD COUNTY, COLORADO
PARCEL 10, HOMESTEAD SUBDIVISION
ISDS
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HIGH COUNTRY ENGINI
14INVERNESSEpONE (303) 2T�544 FAX
1517 BLAKE AyENUE, STE 1 1, GLENVI
PHONE (970) 94543676 FAX
www.t,ca
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