HomeMy WebLinkAbout01205 • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945.8241
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 7t!1 12' a building or use permit.
Owner Frank E. Gulrk /}
System Location 39 Crystal Road, Carbondale �
9�
Licensed Installer Norm Gould & Sons L-a-GV2L) C e • *
* Conditional Construction approval is hereby granted for a 7Fi0 gallon
XX Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in / minutes requires a minimum of 2 2 8 sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms 2 x Z 2 iiq. ft. minimum requirement = a total of 1 ' A. ft. of absorption. area.
May we suggest /2 "Ix 3 8 X 3 " cue e. p * mss'
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Date / /r'Z• Inspecto -' is / Al /diliL..4
/ 0 1 — - Terr y f / °W - i-c
FINAL APPROVAL OF 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 part.
--e2 Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
(g7'I "T-`7"l'7t`tlfiThper materials and assembly.
(/ name of septic tank or aerated treatment unit.
.� P /p6G7 eroiS'°::• c G t' "I>
CJ.' Adequate absorption (or dispersal) area. � �XS� %.3 i ii /S irg G e. :10
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Other
v /
Date Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*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 legalaction 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 I,
Petty Offense (5500.00 fine — 6 months in jail or both).
Applicant: Green Copy Department: Pink Copy
vr INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION PAGE TWO
•
OWNER ,CA 0 74 i E. a /,z .r
ADDRESS 39 / t el Ca//Sns. /a /� - -c, /, rinr PHONE 9e s - c' -se
APPLICANT x-- r .. ,e.-
ADDRESS PHONE
CONTRACTOR Nor m 6 U / d Q serif 5
ADDRESS 00 C /,b1,o‘rdn,,, L,y PHONE 9*3-7Gy/
IS PERMIT FOR: ( y 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 Gec., ,r. /d
Near.. what City or Town A41 4.4- ` Lot Size // aalkur
Legal Description _sec sate. frde rimer
WASTES TYPE: ( 'Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non - domestic Wastes
( ) Other - Describe:
BUILDING OR SERVICE TYPE: , 'p sire -n./a/ Number of Persons .2
Number of Bedrooms �Z
( s "Garbage grinder ( ' Automatic washer ( I-I Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (✓f well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: 7e
If supplied by community water, give name of supplier:
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table: 1),/ r
Percent ground slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to community system?
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:
(z4-Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe:
PAGE THREE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?
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:
SOIL PERCOLATION TEST RESULTS:
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 . completenessof 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 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 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.
Date /ate /8 Signed --7 ,c -c,
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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A parcel of land situated in Lots 5 and 7 of Section 17, Township 7 South,
Range 88 West of the Sixth Principal Meridian, lying southerly of the northerl'
line of said Lot 5, westerly of the easterly line of said Lot 5, and northerly
of the northerly right of way line of County Road No. 113, said parcel of land
is described as follows:
Beginning at a point on the northerly line of said Lot 7 being also the south-
east corner of said Lot 5 whence an iron post with a brass cap found in place
and properly marked for the North Quarter corner of said Section 17 hears
N. 89 °36'08" E. 652.88 feet and N. 00 °17'21" W. 1369.28 feet; thence from said
point of beginning S. 04 °53'53" E. 229.19 feet to a point on the northerly
right of way line of said County Road; thence N. 80 °03'21" W. 95.92 feet along
the northerly right of way line of said County Road; thence N. 58 °29'13" W.
200.00 feet along the northerly right of way line of said County Road; thence
199.68 feet along the northerly right of way line of said County Road, on the
arc of a curve to the right, having a radius of 1169.10 feet and a chord of
which bears N. 53 °35'38" W. 199.43 feet; thence N. 48 °42'04" W. 485.00 feet
along the northerly right of way line of said County Road; thence leaving
said County Road N. 21 °53'23" E. 367.00 feet to a point on the northerly line
- of said Lot 5; thence N. 89 °13'32" E. 629.38 feet along the northerly line of
said Lot 5 to the Northeast corner of said Lot 5; thence S. 00 °21'09" E. 680.3-
feet along the easterly line of said Lot 5 to the Southeast corner of said
Lot 5 the point of beginning.
The above described parcel of land contains 11.15 acres more or less.
October 9, 1978 SCARROW & WALKER /KKBNA, INC.
204 8th Street
Glenwood Springs, CO 81601
V
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Dote
PERCOLATION TEST DATA
Address I Qic /i'ek
Profile hole
TEST HOLE #1 #2 #3
TIME (Min.) Level Drop Level Drop Level Drop
5 2/9' 3 /¢ 3 % - 5 //� 17' -
10 /% / v 3% v - 4 /g
15 i Z¢ %Z 3 %U '/1‘
20 % 3 / q - z Zt % - 3 ' 5
25 ,I //L
30 / � r ai /�1— 1 � Vv C
35
40
45
50
55
60
Percolation Rate / / / 6 7 minutes per inch.