HomeMy WebLinkAbout01523 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
a• Glenwood Springs, Colorado 81801
Phone (303) 945 -8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT '.' 1523 I a building or use permit.
Owner Scott & Sara McAllister
System Location Lot #5, i$wk Ridge Subdivision, Carbondale
Licensed Installer —.— _ . / e'•rt ia t her,o - ark 4444.v/ :•1 s/a / /
Conditional Construction approval is hereby granted for a 414rnsit gallon
teat Ca
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 4 g 3 sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms 3 x �sq. ft. minimum requirement = a total of 44¢¢9q, ft. of absorption area. to
ylay'we suggest: r XC S f i x i d e ep o r 2 ' 4 ' 'PS 4' /'X 3 `de t z
Date // // 3/8 ry ` . Inspector yel AA
FINAL APPROVAL OF SYSTEM:
_rye eeduct Loj rr}to 9g rL a5e9 rr /n�
!!.5 `
Y' r �. !8' pC GS X 3 �d c �c � L¢X¢sx 3 o ve r
No system shall be deemed to be in c mpliance with tFie Sewage e Disposal Laws until the assemble system is approved prior to cove
ing any part.
- Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
P roper materials and as embly. , n f
Co at eA. see c�a / , �o ncrJ2 , ko "We. A /
O � / Trade nafne of septic tank or aera treatment unit. L� / ok ! //8r"+
�l ^ ,/ Adequate absorption (or dispersal) area. ), X .c / , r /1 s' `t� /e a, "?'
0 ' _ Adequate compliance with permit requirements,
Ov■ Adequate compliance with County and State regulations /requirements.
_ Other //�/ /i
Date AZ/Yet? h Inspect�` Y_ — — — --
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS:
1. All Installation mustcomplywith 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. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall
automatically be a violation of 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!, Petty Offense
($500.00 tine — 8 months in Jail or both.).
Applicant: Green Copy Department: Pink Copy
inuiviuUML SEWAGE UISPUSAL SYSTEM APPLICATION Approval by
D OWNER, c= Coke-A ��IST County Official:
AZRESS gfG 5 ti 4°4 4/4, &A. PHONE 90 - )K38"
CONTRACTORi ou ., �) / � `a s It) c•
ADDRESS X 327_ . PHONE947^3 -17C.2_
PERMIT REQUEST FOR: (X New Installation ( ) Alteration
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: CountyC.,,,Mrisi -L>
Near what City of Town CARBOk) Lot Size .5:197 ac.
Legal Description LOT
WASTES TYPE: ( XJ Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non - domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE:
Number of bedrooms - t'Nitea Number of persons - nfra,
(X) Garbage grinder (x) Automatic washer (X) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system:
If supplied by community water, give name or supplier: "'K ? (DG E. ""' "'""-" "'
0n..c()u roc
GROUND CONDITIONS: -
Depth to bedrock:
Depth to first Ground Water Table:
Percent ground slope: 4,
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: .—
Was an effort made to connect to community system?
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(X) Septic Tank ( ) Aeration Plant ( ) Vault
( ) Vault Privy ( ) Composting Toilet
( ) Pit Privy ( ) Recycling, potable use
( ) Incineration Toilet ( ) Recycling, other use
( ) Chemical Toilet ( ) Other - Describe:
FINAL DISPOSAL BY:
(X) 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 ? IslfZ
Page 2
.711. 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:
Natne, 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 4s 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
statements made,
submitted herewith
correct
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. 1 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 a provided by law.
Date g A — N Signed II. �I -1
PLEAS DRAW AND ACCURATE MAP TO YOUR PROPERTY /
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