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8; GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
•A�; • 109 8th Street Suite 303
- Glenwood Springs, Colorado 81601
Phone (303) 945-8212
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This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT 1845 a building or use permit.
Owner
Janes P. ions ' —
System Location Reoeptian No. 298350 Carbondale p 6 n e 4 ' n N t /' , • (, e kz>. -0(
Licensed Installer Stasecre, Inca Construction
Conditional Construction approval is hereby granted for a 6 00 0 gallon
_k_ Septic Tank or — Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in _La__ g
minutes requires a minimum of / 2- sq. ft. of absorption area per bedroom. •
Therefore the no. off bedrooms 3 x , / / 3 lsq. ft. minimum requirement = a total of 7 sq. ft. of absorption area.
May we suggest: Dr tN� l 1 /¢ X i 7 / X /0 • %�//� //�v %/�� /�J
Date , / y l / 9 (� inspector ///j/LL(-
FINAL APPROVAL OF SYSTEM:
�1.� G l� ' " �.
EM: �e c by w Q.6 Oes j//
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.
f %. (�
I Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
L surface.
Proper materials and assembly.
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(. /if; I TV p . « Trade name of septic tank or aerated treatment unit.
(2`i Adequate absorption (or dispersal) area. 7 V ' 1 i 74',./.,)‘ 24 ,
1- Adequate compliance -with permit requirements.
/ Adequate corpliance with r11y and State regulations /requirements.
Other
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Date J ' - InspectorC H-- — Ci�1/ C4
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS:
1. All Installation must comply with all requlrements 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 — 8 months in jail or both.).
Applicant: Green Copy Department: Pink Copy
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval
County Official:
OWNER frIf /1/v).4 ,Perw+'i-
'DDRESS X Aox /,? /R 4 f c-r PHONE 900-33/7 5 . •
S 1 c%D,�f .74'c fe
;ONTRACTOR
b
ADDRESS 3( r c, Gthenior6 )c t PHONE 9l.3- /9S / �GV`.i/ e
'ERMIT REQUEST FOR: (X) New Installation ( ) Alteration ( ) Repair
lttach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable building, location of potable water wells, soil percolation
:est holes, soil profiles in test holes. See page 4.)
.00ATION OF PROPOSED FACILITY: County Cf/-htrne-(2) •
lear what City of Town ( Fr Lot Size /67.OsAceg5
.egal Description 5,)6, S' /,(lt, c Ver 34 RA/6 47
TASTES TYPE: ( >4 Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
WILDING OR SERVICE TYPE: €PS• /S1t
lumber of bedrooms .3 Number of persons
;>4.) Garbage grinder (>4 Automatic washer (X Dishwasher
iOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek
live depth of all wells within 180 feet of system: )f /0 n
If supplied by community water, give name or supplier: L /n,dS , e ( SM? r'
;ROUND CONDITIONS:
)epth to bedrock: -. _ _ /4/0iJ67
)epth to first Ground Water Table: 2,45,4-r,
) ercent ground slope: $- %,
)ISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Jas 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:
FINAL DISPOSAL BY:
(>9 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? 4/0
a
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4 .
'Olt PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.)
Minutes ( G. / per inch in hole No. 1 Minutes 40 per per inch in hole No. 3
Minutes Co, / per inch in hole No. 2 Minutes per inch in hole No.
lame, address and telephone of RPE who made soil absorption tests: 54 mt f"i'✓c
go-twit S?q&
lame, address and telephone of RPE responsible for design of the system Vt9!3l fr.9 fr - a
/vC437- (x= rer,; 90 6'C ,, c
1pp11cant acknowledges that the completeness of the application is conditional upon such
' urther mandatory and additional tests and reports as may be required by the local health
lepartment to be made and furnished by the applicant or by the local health department for
)urposes of the evaluation of the application; and the issuance of the periiiftis'subdect to
:uch terms and conditions as deemed necessary to insure compliance with rules and regulations
.dopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies
:hat 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
)f 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 -
;tend that any falsification or misrepresentation may result in the denial of the application
)r revocation of any permit granted based upon said application and in legal action for per -
iury as provided by law.
)ate /A JO f Signed . r.rr 'LEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
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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.
frxe 7�-r sdce, »Fa 4 00 •
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Page 4
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SOIL PERCOLATION TEST SUN PEAK ENGINEERING
P0 5796
Woond Park, CO 80866
719 7 -6232
REPORT: 010 -50 :LOCATION: 1 — r
!CLIENT: Statsmore Inc t
(ADDRESS: 312 S. Meant
CITY /ZIP: Carbondale, CO 81623
1 03
TEST LOCATION Lot 15, Blk 1, Lions Ridge 89 ` 4
Estates #1, Garfield County, , p: 37 '
CO �0 34
TEST DATE: 10/22/90 ` 4'
az
1 HOLE #1 :HO #2 'HOLE #3 I*
s PaoF �� pat* c ' N `
TIME DEPTH 50" DEPTH 48" ;DEPTH 38" P , ... — i
INCH' DROP INCH' DROP' INCH' DROP "o
1 1:20 11.75 12.50 1 13.25 1 m CUT SRN1G
1:25 1 1.38 1.751 1 1.75
11:30 1 1.12 1.3 1.501
1 1 : 35 1.00 1.12I 1.25
1:40 .88 1.001 1.12
1:45 .75 88, 1.00,SOIL PROFILE
1 1:50 .75 .88 .88 DEPTH ' SOIL DESCRIPTION
'1:55 .75 12:00 .62 .75 .8 81 0 -12' very soft,
moisture.
2:05 .62! .75 .75 1
'AVG = 8.1 AVG = 6.7 AVG = 6.7 1 I
' 1 1 ' GROUNDWATER: None
AVERAGE = 7.2 MIN /IN 'BEDROCK: None
COMMENTS:
The proposed site for the septic absorption system lies along a
southern slope with a grade of approximately 5%. Ground
cover consists of native grasses.
A seepage bed or absorption trench system would be recommended
for this site and the design should be based on a soil
percolation rate of 7.2 minutes per inch. All minimum distances
must be maintained in accordance with the Garfield County Health
Department regulations. A cut bank up to 4/ high exisits along
the southern property line. The absorption area should be no
closer than 10 times the height of any cut bank. 41
1 eppO0" ls