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Home My WebLink About01142 GARFIELD COUNTY BUILDING AND SANITATION ON DEPARTMENT �v 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945-8241 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT - 4? 1142 a building or use permit. Owner Rirhard Miller 7? is' 1 • ¢_— System Location Township 5 South, Range 93 West of the 6th p.m. Section 15 Licensed Installer • Conditional Construction approval is hereby granted for a 1 gallon xx Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Pero rate of one inch in inutes requires a minimum of / V "sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms _ ooms D � t x sq. ft. minimum requirement = a total of sq. ft. of absorption area. May we suggest f 9 X 613 r K AM1 lM . � I - t,n-"., i.c r�� c 14 -1„, ( ri- \ ,... Date n 1 4 Z.. T �re a 1Gt-t � I 14 Inspector FINAL APPROVAL F SYSTEM: No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover- ing any pa ®4 1 Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. mbly. /- ‘ '1 ,/e_7 ov'��e � K Proper material and ass� / � � °°'-"� if � moo® E' cs+�a -K / o s. so a� (. L. /C 7C. c o v o. h- Col /lri' J— O C Tradellame of septic tank or aerated tr atment unit. 0 Adequate absorption (or dispersal) area. (9 X Adequate compliance with permit requirements. OAS Adequate compliance with County and State regulations /requirements. (e - Oth�er��C k Date %5 O' ' Inspecto Id RETAIN WITH RECEIPT RECORDS ONSTRUCTION SITff 'CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au- thority granted in 66-44-4, CRS 1963, amended 66-3-14, CRS 1963. 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viola- tion of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Section III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in- volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class 1, Petty Offense (5500.00 fine — 6 months in jail or both). Applicant: Green Copy Department: Pink Copy aaaa..a......—.... ....... sa..aa t ann. .n adareaulla SAILailLaNsf fra.u.uu�ra :eu.uu.....a a. .�. INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION PAGE 1110 OWNER ?/./seveh Y � + 1 r2 �/ ��— - -- .. - -- ADDRESS �Q � x _ 70 7 ._ ae._ n \P0t_ [ ��aPH0NE 1'5j 2( APPLICANT _y , z,C__al ,ei oe•"& — ADDRESS T _ _ PHONE CONTRACTOR — ' _ : - t /97 , od.0 ADDRESS — ��« —_� PHONE _ _— _ - -._— IS PERMIT FOR: O New Installation ( ) Alteration ( ) Repair Attach separate sheets,or.report showing entire area with respect to surrounding areas, topography .of area, .habitable buildings, location of potable water wells, soil percolation test holes, soil'profiles in test holes. LOCATION OF PROPOSED_ FACILITY: County 4Z*3C'E,I _ Near. what City or Tbwh -jt! 4 • -_ Lot Size 0 29 e feaeroeria.. 5 Legal Description ,p,S,w;,o ar a A)4 , r 93e.)Esr nr of( 1 :1 //.C.0 ,>,c- YdAT Rber nF'»'r 4)72 1Oc3YY____SagatiCe J/ Rr.Jb (iEfl of as. tlYe.3 13 WASTES TYPE: ') Dwelling( ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe: BUILDING OR SERVICE TYPE: _th/e y _ Number of Persons _3 __ Number of Bedrooms . ?_' ___ ( ) Garbage grinder ( )Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: () i well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: 7a 17E ,%>2/4ctx0 If supplied by community water, give name of supplier: _ GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: Percent ground slope: , -?,?2c;' - -- DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? zJ' _ TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: _QC) 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: PAGE 1HNL E ie l? :.1 e WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ' ^/L JQ _ .. ,._______ SYSTEM IS DESIGNED FOR ______ ^___!_____ GALLONS PER DAY'. If the system is to be designed by a Registered Professional Engineer (RPE), state .. . rate of absorption in test,holes shown on the location map,'in minutes per inch ., of drop in water level after: holes have been - soaked for 24 hours:N_r ,'_ _______ SOIL PERCOLATION. TEST RESULTS:._ , . Minutes __ per inch in hole No.'1 • Minutes T__ 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 purposes 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 adopted under Article 10, Title 25, C.R.S. 1973 as amended. The undersigned hereby certifies that all statements made, information and reports submitted herewith and required to be • submitted by the applicant'are -pr - 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 sane for purposes 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 an permit granted based upon said application and in legal action for perjury . pro id:; my law.:. Al Date fi /i/ ,. I l-_`� — Signed ` �.�A�� PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY IV ire, „ 6 pk� //11 PF7- F (1;Ty 1 s ( , h i T u,S (3 10 0 l 1 1-1 PAGE FOUR PLOT PLAN AND DESIGN FEATURES: Include by measured distance location of wells; springs, potable water supply lines, cisterns, buildings, property lines, subsoil drains, lake, water course, ir stream, dry gulch and show location of proposed systgm by direction and distance from dwelling'or other reference and additional submissions in ir.., support of this, application such -as data, plans, specifications, statements and commitments. Goy ec g peox ) - lou3c nNl( rinD 1 3-0 • . -- -- -- __I� 1 \ Date 4 '3 /fir — , 41„ f jester , v PERCOLATION TEST DATA Address �, `{� — kge.A_ _. Profile hole •.,.. # ( ,. %...� TEST HOLE #1 p2 #3 TIME (Min.) Level Drop Level Drop Level Drop 5 (% 510 1 / / li 10 �� 66 z; I- 15 G / 3/ �, � ' 7 A n 20 co / J 4 % " 3 'r 3 1l !jv 25 /�, II 17 n : (!/ 35 40 45 50 55 60 Percolation Rate r minutes per inch.