HomeMy WebLinkAbout01491 •
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
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2014 Blake Avenue
P4' Glenwood Springs, Colorado 81601
Phone (303) 945-8241
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT le 1491 a building or use permit.
Owner STEVENS. Jim
System Location 3712 County Raod 214 - Silt
Licensed Installer Tom Walker ,Ay
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Conditional Construction approval is hereby granted for a il%l7 0 gallon
Septic Tank or Aerated treatment unit. •
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in All' minutes requireesa minimum of 412t7 sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms x sq. ft. minimum requirement k = total of tiQar� sq. ft. of absorption area.
• May we suggest /'22‹, & dam cite f r,r / >T fi ''' F P p •
Date --� / rg'is At
, 4
`s+�j� Inspector ��� j
FINAL APPROVAL OF SYSTEM: 7 147
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.
Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
U K Proper materials and assembly.
' i.r Trade name of septic tank or aerated treatment unit. elye w-�++ 1p D O. ett Cep
2 ; , f ` Adequate absorption (or dispersal) area. /n c / /! p r / S . 1_ e
(7/< Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
-- —Other
Date (19// (/e Inspector it
P
RETAIN WITH RECEIPT RECORDS AT •NSTRUCTION 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 I11, 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 ($500.00 fine — 6 months in jail or both).
Applicant: Green Copy Department: Pink COPY
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PO GARFIELD COUNTY
ENVIRONMENTAL HEALTH DEPARTMENT
PROCEDURE REQUIRED FOR COMPLIANCE WITH THE GARFIELD COUNTY SEWAGE DISPOSAL REGULATIONS:
Step I: Application
A. Obtain a standard "Individual Sewage Disposal System application"
from the Environmental Health Department - 2014 Blake Avenue,
Glenwood Springs, Colorado 81601 - 945 -2339 or 625 -3321.
B. Return completed application, map to property, and diagram of site to the
Environmental Health Department (pages 2,3 & 4).
C. Obtain a' receipt for the applicable fee. Make check or Money Order payable
• to `Garfield County Treasurer ". FEES ARE NOT REFUNDABLE.
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Step IL:: Percolation Tests - SEE DETAILED INSTRUCTIONS ON PAGE 6
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*A ^Prepare three percolation,ho.les 4 feet 7 deeP,T8 to - -12 inches in diameter, .
and 20 feet apart in the area of the proposed leach field.
B. - Fill percolation holes with water once for the required 8 hour soaking period. i?
C. Request percolation test by Sanitarian. (To avoid construction delay, we
suggest arrangements for percolation test be made at least 24 hours prior
to the end of the soaking period.) Please have at least 10 gallons of water
available at the site for the percolation test.
, , + � ° r n. 99�mnppa � m�°� yys�u. ndiviciuth „§ ia9ftapo af + ' i :,bg ssu airo
no prof ibis OiNieiS encountered'. ( ' '!
*If a drywell (seelage pit) is proposed, consult with the-Environmental ,
Department for percolation test procedures.
4 11MPORTANTIU741tase>be- redvised' that if that- Sanitafl1an's; initial field ris t to a;.
property reveals any unusual difficulties such as•high water .table,
excessive: percolation rates, bedrock, etc., the services of a
;Colorado Registered Professional-Engineer and /or Board of Health:
approval will be required prior to the issuance of your Individual -
Sewage Disposal System permit. •
Step III: Final .Inspection
A. When all components are in place, connected and ready to cover, request•final:
inspection by the Sanitarian.
B. DO NOT backfill any part of the - system prior to inspection.
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C. Upon final approval, carefully cover entire system.
Please,_ feel free to contact the Environmental Wealth Department if any questions regarding:, _ n'
�cn it individu�•1 sewage treatment sys m, arise
G
(FOR APPLICANTS`Ii1FORMATION)
1NUlVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval u
,-OWNER C4 u.t n,$ e p It,s"t County Official:
ADDRESS OX 61&6' PHONE 96 /- /52
CONTRACTOR_ % p n 4.01 N( , a--v-
ADDRESS 1531 M , wa el 3.3 e 6. ow ,11,4 /e PHONE 961 -'a 419
PERMIT REQUEST FOR: ( ) hew 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 Q W+IC y, �
Near what City of Town S'111 Lot Size 7.• hCv-e...
Legal Description Rcpc 0411 9 m'Vov svo Dist/
WASTES TYPE: ( welling
( ) Transient Use
( ) Commercial or Institutional ( ) Non - domestic Wastes
( ) Other- Describe
BUILDING OR SERVICE TYPE: R a.S 4
Number of bedrooms
1�'1 K Number of persons y
( loetcbage grinder ( Jot washer ( ✓rDishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( Iirwell ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system:
If supplied by community water, give name or supplier:
GROUND CONDITIONS:
J epth ,to..bedrock: it, .�,
,. •%' =- . : tr va+ • . � :... (Or aroma:: .<, ;:'.+k. r+ vµ :F
Depth to first Ground Water Table:
Percent ground slope: S
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: a' n;; /K. S
Was an effort made to connect to; community rsystem? • Y V 0
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(✓rSeptic Tank ( ) Aeration Plant ( ) Vault
( ) Vault Privy ( ) Composting Toilet ( ) Recycling,.potable use
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( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use
( ) Chemical Toilet ( ) Other - Describe: •
FINAL DISPOSAL BY:
( rYAbsorption 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? fV ......
Page 2 .;_
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•SUL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.)
it nutes 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 petimit4v.subjeot 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 - ;.
flsificatio and innlegalfactionor application
per
jury as provided by law.
Date �/ I"-1 Fr /.
Signed as..
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
/.
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