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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (309) 945-8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 7 '4 9 1 804 a building or use permit.
Owner (Sandy Rnl t11
System Location 3059 103 Rd. C1 +rb nY3Ale
Licensed Installer Iiei13o11/Zt>eb Cbnstructim Cos
Conditional Construction approval is hereby granted for a , 0,' gallon
— Septic Tank or _ Aerated treatment unit.
Absorption area (or dispersal areal computed as follows:
Perc rate of one inch in / ', _ minutes requires a minimum of ) 7 9' sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms 3 x n 7 sq. ft. minimum requirement = a total of y ` 'j 7 sq. ft. of absorption area.
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May we suggest: i
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Date / ' - '? l) Inspector ' j..._. ) 1 •
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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•
in any part.
/f 0 - 4 13- 0 .. Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface. ,
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Proper materials and assembly. L.
M rrk i4400 Trade name of septic tank or aerated treatment unit.
/ � /l,( s/ Adequate absorption (or dispersal) area.
// __
v / /— Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
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Date f -r 4 7.0a __ _ Inspector _
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION 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 1964.
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 1
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 1, Petty Offense i
($500.00 fine — 6 months in )ail or both.).
Applicant: Green Copy Department: Pink Copy
Application
;. INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
OWNER Sandy Smith County Official:
ADDRESS 3059 103 Road PHONE 963 -3507
CONTRACTOR Nelson /Zeeb Construction Company, Inc.
ADDRESS Drawer 5400, Avon, CO 81620 PHONE 949 -5152
PERMIT REQUEST FOR: (X ) 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 Carbondale Lot Size 35 acres
Legal Description see attachment
WASTES TYPE: ( X ) Dwelling
( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE:
Number of bedrooms 3 Number of persons 2
( X) Garbage grinder (X ) Automatic washer (X ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( X ) well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: N/A
If supplied by community water, give name or supplier: N/A
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table:
Percent ground slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: None
Was an effort made to connect to community system? No
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( X) 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:
( 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? No
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