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Home My WebLink About01441 j Pk t 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 4i1 1441 a building or use permit. Owner Ken and Jfmnie Collins System Location 2384 Highway 325 Rifle Licensed Installer self Conditional Construction approval is hereby granted for a gallon 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 sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x sq. ft. minimum requirement = a total of sq. ft. of absorption area. May we suggest /,f i/,/ /!t /ti —/a41% „_, 240 Date "• Inspector FINAL APPROVAL OF SYSTEM: ACC/ Q ��audi 1,,, /g d'6 -or .* , 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. — L / / �1 , L�/ / S� �, 2i V eptic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. Proper materials and assembly. Trade name of septic tank or aerated treatment unit. Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. 7er eg 1 / L a.�) Date (Q ` Inspector s �.i /. 6(. ��ifrGL O /// 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 legal action and revocation of the permit. 3. Section 111, 124 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 (8500.00 fine — 6 months in jail or both). Applicant: Green Copy Department: Pink Copy ___ ..a.. . uW/Wa- pWASSamaaaeauauaeraaaa sans anus. sass u an.... am. sm. u... ............. INDIVIDUAL SEWAGE DISNUSAL SYSTEM AFVLICAIIUN i ye ,v.u. County Official: 'OWNER Ken and Jimmie Collins ADDRESS 2384 State Highway 325, Rifle, Co. PHONE 625 -1418 CONTRACTOR_ none ADDRESS PHONE 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: County GARFIELD Near what City of Town Rifle . Lot Size 320 acres Legal Description on conditional use permit application approved conclitionallyjayadssioners on May 28, 1985 WASTES TYPE: ( ) Dwelling ( ) Transient Use ( ) Commercial or Institutional ( ) Non- domestic Wastes ( ) Other - Describe mobile BUILDING OR SERVICE TYPE: see page 2 Number of bedrooms Number of persons ( ) Garbage grinder ( ) Automatic washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring • ( ) stream or creek Give depth of ali wells within 180 feet of system: If supplied by community water, give name or supplier: GROUND CONDITIONS: Depth to bedrock: Depth to first Ground Water Table: 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: INAL DiSPOSAL BY: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Underground Dispersal ( ) Sand filter ( ) Above Ground Dispersal ( ) Wastewater Pond • ( ) Other - Describe: ILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? • BUILDING TYPE: Existing home is rated as three bedroom because the studio- loft area is considered a potential bedroom. Only one bedroom in the home is utilized by Mr. and Mrs. Collins. The other bedroom is for a guest room, and the loft is being used as an office. Therefore it should be possible to hook the mobile home into the same septic system without any overflow problem. A couple will be living in the mobile home, (family). Therefore the total number of people using the septic system will be four. The existing system was rebuilt per application dated 10- 26 -78, in the name of Pierce Mangurian. Collins recently had the septic tank pumped by MtGruder Septic Service and they said the tank was 1250 gal. Collins has made arrangements for MOGruder to check the tank every four to six weeks for any problems. We propose using the existing system under the existing conditions for the mobile home. Map indicating locations is attached to original application dated 10- 26 -78, copy attached hereto. Page 2 v SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.) • 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 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 of issuing the permit applied for herein. I further under- stand 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 per- jury as provided by law. • Date Signed en. ( PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • • • Page 3 i`.. 'Fees Paid $ INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLIi. ION Date %r ( lc NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM • aer: - ' -r, e`�7 � Mali Address: q 5 ��,. 3, City: ,C, r€ cr Zip: ,4 Phone: f -; si j INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percola- tion test holes, soil profiles in test holes. 1. Location of facility: County Garfield City or Town Legal Description ,7=z -,: ,;,Lot Si ze Wit_ — i>c 2. No. of Bedrooms > , � �• Septic Tank Capacity,/,- ,,•:• : - Aeration Unit Capacity 3 ,, i c/,`o,vre,4? -L C /C - 30 • -7 8 w 7 " , / C T/.%�f e-rV ,.-4- -inc-S <. Source of Domestic Water: Public (name): Private: Well >c, Depth Other Depth to first ground water table .. Is facility within boundaries of a city /town or sanitation district? -VC' Distance to nearest sewer system: — i Have you attempted to arrange a connection with the system? / f G If rejected, what was the reason? 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: • Name, address, and telephone of person who made soil absorption tests: • Name, address, and telephone of person responsible for design of the system: ▪ Express permission is hereby granted for the inspection of the above property by any member of the Garfield County Environmental Health Department and /or such persons as they may designate. Any withdrawal of this permission shall be in writing and receipt acknowledged by the County Environmental Health Department. ▪ I have been given an opportunity to read the Individual Disposal Systems Regulations of Garfield County and I hereby agree to comply with all terms, conditions and requirements included therein. ,• Date Signature of Applicant • t C ci Cl t Cic`j (TO BE RETURNED TO HEALTH DEPT.) • : • PLEASE AW AN ACCURATE MAP TO YOUR PRl RTY • • , , �` f 1.1 I -4 F! rc."7!1- i t INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES 1 • IL � j • . (SO BE RETURNED_ TO HEALTH _DEPT_ )