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Home My WebLink About02111 " r GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N- 2 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81801 Phone (303) 945 -8212 This does not constitute a INDIVIDUAL4SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY r David E. Frames Powell Box 1186, Carbondale 963 -9869 Owner's Name Present Address Phone 0104 Wooden Dear Road, Carbondale System Location Legal Description of Assessor's Parcel No. yq 1: SYSTEM DESIGN 4 0 0 Septic Tank Capacity (gallon) Other / S Percolation C erco lation Rate (minutes/inch) Number of Bedrooms (or other) 3 Required Absorption Area • See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours (124 notice) Before Covering Installation \ System Installer ( f y2t/ Septic Tank Capacity / `' 3 Septic Tank Manufacturer or Trade Name ; !` -" - " (.. /, C . Septic Tank Access within 8" of surface • Absorption Area r� Absorption Area Type and /or Manufacturer or Trade Name rl ' CPC " t` ' ' .' -e .. t Adequate compliance with County and State regulations /requirements l . Other �..., ' / Date / Inspector ,_ !Pi/ .4+ 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 1984. 1 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or 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 )ail or both). Applicant: Green Copy Department: Pink Copy Application INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by — County Official: OWNER DAc4p gW 2 - cc. ADDRESS a lb`/ 4lz� RP PHONE erd3 --t�G7 CONTRACTOR pi*/ /- ADDRESS l'Ordc. -e / C PHONE 9 3 - 9X, i' PERMIT REQUEST FOR: (ew 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 6.4cpzatll Near what City of Town /'p,Ac -C Lot Size JP,efce) Legal Description Loy` vr/ CJ Sac 5-6:50, _ WASTES TYPE: ( ..Ybwel1ing ( ) Transient Use ( ) Commercial or Institutional ( ) Non - domestic Wastes ( ) Other - Describe _ BUILDING OR SERVICE TYPE: Raft) _ Plumber of bedrooms 'a Number of persons / ( Garbage grinder ( 'l Automatic washer ( Dishwasher SOURCE AND TYPE OF WATER SUPPLY: ( well ( ) spring ( ) stream or creek Give depth of all wells within 180 feet of system: ,f/bre If supplied by conununity water, give name or supplier: t✓ala9rrhG 5 , GROUND CONDITIONS: Depth to bedrock: t -(AJ1c _ Depth to first Ground Water Table: G(,i!< Percent ground slope: f DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: S eciff c_.-i Was an effort made to connect to community system? W b • 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: ( 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? /J6 • • SOIL 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 /5 per inch in hole No.A4-4 Nance, address and telephone of RPE who made soil absorption tests : /..4dia .A Fc,Igc_ 0aX 63/ donyte Co Q /62j 116 ^W >6 Name, address and telephone of RPE responsible for design of the system: S1.1a e- 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 permft,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 sane 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 .67 Signed �.edec - 0--4--- PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY • • Paae 3 v 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 connitments. Page 4 • ADOBE DESIGNS David Powell, P.E. Post 011 ice Box 631 Carbondale, Colorado 81623 (303) 963 - 9869 April 26, 1993 Garfield County Building Department Subject: Individual Sewage Disposal System, Proposed single family residence at Lot 22, Wooden Deer Subdivision, Garfield County, Colorado Gent 1 omen : Percolation tests were conducted at the subject site on Octeher 17, 1992. . The findings of the work and recommendations are presented in this report. Three holes were running in an approximate triangle, 20 feet part and south of the proposed residence were tested. The holes were approximately 3 feet deep with another 1 foot depth created by digging with a post hole digger. The holes were filled with water 24 hours prior to the testing and were refilled with water to a depth of 10 inches prior to final measurement. The average time for the three holes was 15 minutes. The area required for leaching will be 837 square feet and the minimum tank size will be 1000 gallons. If there are any questions please let me know. • Si.... - i ii r acid A:` el n .,R �t :ON 0 i • .