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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
COMPne 109 8th Street Suite 303
Fe, GA / a lenwOod
Phone (3 3) 45 82d2 81801
<S`CC 9nOoH�9
/ a y This does not constitute
T 1t ! a building or use permit.
/ 'o' fys - t.-i /nfitotirrt .
C� S 'rz7floDef _ siziNf FO a , or
for a / UU U r
SEA RrtH�cD Fo/CT�N/'(
gallon Rre:ovu ri47NTS•
ient unit. /rr4Gp; g e !r X
1 Is: 4: /f2SxGa aGOrOwsig-oo
( p a rer R �rn. wAree S.r/ .11 x s- 9/6 = a, /Jo4
SL ��rLr: ' sq. ft. tot absorption area per bedroom.Par- —
ninimum of '¢ -
/
ovr o/s #/'r-•jo 9e,�' r q. ft. minimum requirement = a total of y l..�, ft, of absorption area.
S 401•4'' w / e 9r 9 , p XsS� /....x J 3 ye e
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bit �.1.
n A?� p for ( t.t C /'� 7 ..A.t -r9'
FINAL APPROVAL O SYSTEM: 1
r/raNU../ r. /0e Qr r 62.E , il
No system shall be c�e Al the assembl to be in compliance with the Sewage Disposal Laws u thbl d sysigm is approved prigr to cover•
' in a tt. F/t?r9QYfl'�S n.._�.
-- / - Septic Ta n access or inspection am. . • • 6. e --( be-ground-
surface. ‘3 E._ o
L 8 _ /1 rL
,.J ft Proper materials and assembly. .• i i c—Xt Y / / �' 6/�
Trade name of septic tank or aerated treatment ui 5— Jl, V V
OK Adequate absorption (or dispersal) area. 24 /,,V x `'o/ " ✓( pic /et.
Vti. -- Adequate compliance with permit requirements. / `' J 15 �
/ . / 0
4.2i-C, Adequate compliance with County and State regu
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_ 0 her _ � p ca. 74.5/.7 0
fp Ze
Dat O v _ __._. -_____ Insp T�w<r� ___
RETAIN WITH RECEIPT RECORD - -_� ? r 0 X32
630 io Boo 7S6tf drrT
*CONDITIONS:
1. All installation must comply with 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 I n 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
' ' ' •+ ? • GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81801
Phone (303) 945 -8212
WE JJDT/rt aft.- g 1T9f%H�'
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 112 1572 a building or use permit.
Owner Keith Bllnkinsoph — fO/l yyrr/ r I �lle2al�i"n r,ij -.
System Location 3402 Id. 103 Carl: male 6 9 - 93
Licensed Installer _fli.nnr Si WA' 5 FO A fairnoOn
6776tH OEo ro WN11
Conditional Construction approval is hereby granted for a SEA: ,t7 / 00 0 gallon Rico wee' /f RNT.S,
::l Septic Tank or _ Aerated treatment unit. F /K e0 ^ g r N x vL
R_ //2,5 x
Absorption area (or dispersal area) computed as follows:
119—°— 6e a so , ow ..7. /,�00'
1�^ /_ XS. 9 = adefO ?
Perc rate of one inch in ?S7 minutes requires a minimum of 44 L CP sq. ft. bt absorption area per bedroom.D /JVOZret.
Therefore the no. of bedrooms ,j x T 4 sq. ft. minimum requirement = a total of /27' . ft. of absorption area.
May we suggest: /c7 7/ / X ? / C. -/e p 1- L /1 s '- J( / C.l.f' .l' i 1..
Date– ccl /7 Inspector .1 /// //. - _.._al _
FINAL APPROVAL Of SYSTEM: 77M/dc/.4 r /0( -i Qco r 42/ //J . i
No system shall be de rued to be in compliance with the Sewage Disposal Laws until the assembldd syst m its approved prior to cover-
' ingar`ff rt. qL ?ri
• (� Septic T an� acT cess r ms action am, 7 � � D/rb ✓t
'/24t
p
surface. • 2 FO G 34
k l i n, Proper materials and assembly. • ., •-• , •
/ J n Trade name of septic tank or aerated treatment unit. / - pe! a c/ / c a 1 / t, i
?4/ / •
<Jr� Adequate absorption (or dispersal) are `- J '
• /o �/' 1 ( 5 ! ✓IS �L1 P� t
— v , C. Adequate compliance with permit requirements.
e et, Adequate compliance with County and State regulations /requirements.
J _ 0 her / (` ,
Date 47 _ -- --- - - ---- - Inspector ICE . _-/
RETAIN WITH RECEIPT RECORDSCNSTRUCTION SITE
'CONDITIONS:
1. All Installation must comply with 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 I, Petty Offense
($500.00 fine – 6 months in jail or both.).
Applicant: Green Copy Department: Pink Copy
\ 1
SEPTIC TANK SIZE BASED UPON NUMBER OF BEDROOMS
/NFOgn9
Minimum Effective Liquid
Number of Bedrooms Tank Capacity (gallons)
2 750
3 1000
4 1250
Each Additional 250
Jr /5
b. Septic tank design criteria:
(1) Except for grey water systems the
effective liquid capacity shall be no
less than 750 gallons.
(2) Inlet invert shall be at least 3 inches
higher than the outlet invert.
(3) Outlet tee or baffle shall extend above
the surface of the liquid to within one
inch of the underside of the tank top and
shall extend at least 14 inches below the
outlet invert.
(4) The distance from the outlet invert to
the underside of the tank top shall be at
least 10 inches.
(5) Liquid depth shall be a minimum of 30
inches and the maximum depth shall not
exceed the tank length or 60 inches,
whichever is less.
(6) A septic tank shall have two or more
compartments or more than one tank may be
used in series to provide the following
capacity arrangement. The first
compartment of a septic tank shall hold
no less than 1/2 of the required
effective capacity. 7
(7) The transfer of liquid from the first
30
• v
compartment to the second or successive
compartment shall be made at a liquid
depth of at least 14 inches below the
outlet invert, but not in the sludge
zone.
(8) At least one access no less than 20
inches across shall be provided in each
compartment of a tank.
(9) The opening cover of a septic tank
manhole, inspection port, or sampling
access port shall be no deeper than 8
inches below the finished grade, and made
of materials resistant to degradation
from moisture or sewer gases.
c. Pipe meeting or exceeding ASTM standard 3034
properly supported to prevent failure by
settling shall extend from the septic tank for
a distance of at least five (5) feet from the
inlet and outlet ends.
2. Aerobic Sewage Treatment System:
a. General Design: The shape and design of an
aeration compartment, its inlet and outlet
arrangements, baffling and air application
shall:
(1) Allow for intimate mixing of applied
sewage, return solids, and applied air.
(2) Prevent excessive short circuiting of
flow.
(3) Prevent the deposition and buildup of
solids in the aeration compartment.
b. Method of Aeration: The method of aeration
shall be accomplished by mechanical aeration,
diffused air, or a combination of these. The
method of aeration shall at all times maintain
aerobic conditions at the maximum organic
loading in both the aeration and settling
compartments.
31
INI)_IVIDUA_L SIL_LJAGL DISPUSA,L SYS]Ltl Al PLIC/1l IUN Appruvoi by
•
OWNER County Official:
ADDRESS 3402. - R o in?) PHONE `7(0 * ')
CONTRACTOR (��
ADDRESS = PHONE —
PERMIT REQUEST FOR: ( V) 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 0 % �1�cD
Near what City of Town `ag- f3o1-50f{L.L? Lot Size 12, AsTe
Legal Description
WASTES TYPE: ( d) Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non - domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE:
Number of bedrooms 3 Number of persons S
(V) Garbage grinder (✓) Automatic washer (1) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( v") well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: NOkJLS,
If supplied by community water, give name or supplier:
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table:
Percent ground slope: Slip
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: -
Was an effort made to connect to community system? 1.10
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:
(V) 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?
Page 2 •
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,
stream, dry gulch and show location of proposed system by direction and distance
from dwelling or other fixed reference object, and additional submissions in
support of this application such as data, plans, specifications, statements and
commitments.
'..:> Now
20t 401 21
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Page 4
4- SOIC 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
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY I I
t24- 41/21
Sot Rh 103
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Page 3
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ADDRESS
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PO Box 129
1- ?ALE, CC 81623
25--1470 963-3829
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NAME
ADDRESS
72; ,./e_.40.- a C417 SK
CASH COD I CHARGE I ON ACCT.
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C RECEIVED aY ;
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141 thanlicibu ;
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All claims and returned goods MUST be accompanied by Ms bill.
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