HomeMy WebLinkAbout02441 • S . s
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permlt N 2 4 41 il.
109 8th Street Suite 303 Assessor's•Parcel No. , h
Glenwood Springs, Colorado 81801 f,
. Phone (303) 945-8212 8
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This does not constitute k g
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or use permit. 4 #
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building ,
PROPERTY !j'i ? t'.
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Owner's Name T. Rickert Miller Present Address P.O. Drawer 700, Jensen Bench, 407 - 229 -9976 k r
System Location 0 441 County Road 170, Carbondale a
Legal Description of Assessor's Parcel No. A c
fx `=- x VT
SYSTEM DESIGN t
Septic Tank Capacity (gallon) Other i , '
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4 c'r a (: r:A' 7 IOP O f /t
Percolation Rate (minutes /inch) Number of Bedrooms (or other) .........---- • °- - -•�^
- t / , I F/ To'i. /
Required Absorption Area - See Attached /(4 PC/1 Cr O
Special Setback Requirements: 6•t 0 0,37
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Date Inspector t .p
FINAL SYSTEM INSPECTION AND APPROVAL (as installed) ,
Call for Inspection (24 hours notice) Before Covering Installation R ,1:
System Installer ti tpgil 1�7�
Septic Tank Capacity /.S 1)O t
Septic Tank Manufacturer or Trade Name A/r\ P 412/"---04' 1. tS9
Septic Tank Access within 8" of surface 13 ; �
Absorption Area 'p 32 1 3
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Absorption Area Type and /or Manufacturer or Trade Name ,. 37 4 -/ .V 1- ,47,01747RS' < - r s ell a
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Adequate compliance with County and State regulations /requirements 5)6: cr. dt
Other {
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Date 7 . _7/ ` % C Inspector . • _ .. .
RETAIN WITH RECEIPT RECORDS AT ,- CONSTRU TION SITE
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*CONDITIONS: i1
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. 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 N
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 I ` 1
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 8 1 C
months in jail or both). 1
Applicant: Green Copy Department: Pink Copy #1 }
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INLIYIRUAL.SEWAGE_LISI OSAI, SYSTEM APPT.TCATTON
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OWNER uG Karen M IJ(Cr
ADDRESS p0• t4ox loo -Vitt u. Mott, riA • 3 pJ - LONE 461 -221 -1533
CONTRACTOR Pi.U.Cor 4h&.,kten Ue.
ADDRESS P4. W 2-Stei l v ned ) ,t- PHONE 9t a - 1190
PERMIT REQUEST FOR (y)'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).
LOCATION4CP_R_OOPOSE FACILITY: COUNTY Cri-e alcl
Near what City or Town (2 Len of o l.4 Lot 0-2
L egal Description $w _ o o ,. g. ; a-( the.
(t f.m.
WASTES TYPE: (Dwelling ( ) Transient Use
( ) Commercial or Industrial ( ) Non - domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: £'u„ tL. 0-
Nu nber of bedrooms: S Number of persons
Garbage Grinder (✓) Automatic W sher (Dishwasher
I
SOURCE AND TYPE O WATEILSUPPI.Y: (4WELL () SPRING () STREAM OR CREEK
Give depth of all wells within 180 feet of system: I/11k
If supplied by communtiy water, give name of supplier: AI ' k
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table:
Percent Ground Slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Lialintnol
Was an effort made to connect to community system?
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
OF INDIVIDUAL
( ) 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 DTSCIIARGED DIRECTLY INTO WATERS OF THE STATE? Ile
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P_1ILCQLATIOI'LTEST_RESULTS: (To be completed by Registered Professional Engineer) i
Minutes per inch in hole No. 1 Minutes per inch in Bole 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 thecompleteness of the appliction 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 inusre compliance with
rules and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby
certifies that all statements make, 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 hre relied on by the local department of' health in evluating the same fro purposes of issuing ,
the permit applied for herein. 1 further understand 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 perjury as ided by law.
Sign- r Date 11 (13 I C
PLEAS B DRAWS! AN.ACQL!ItATE.MAI.TO Yell !LIMON?, R TY
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' /ATED IN S.a 7..7 S., R87 1. OF THE 6th P..i
CARFIELD COUNTY, COLORADO
/ A - 08.42'19' ,• 2140144.
R . .391.81' ^ R 447.81'
L = 59.5r / L = 169.44'
S 74 E
59.47. 69 ' 7 49 • S 168.43 E N 88301' E
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IN PARCEL ! S far E
`■ BARAN PROPERTY
EXISRNC � a
MELLHEAD �I 5 61 .3{r E
' S 11 0 49' E
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e PARCEL 2
43 anew PROPERTY
MusArc & 2,a1 10 W
510 E
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e BEGAN PROPERTY
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AOMORI 1D COLMAM 1.4g R w NT MOM Nt! IFC4 ACTION 4 D uw ANI'
N 88'45 25' W 468.00' COMr w ws SIRI[Y *INN s lugs NW w msr dsooa SLVI mitt. w
Yu 00(7 Mr ANY ACw4 MuO teat µr mm N NS SACK COW= li I[
9W1 OWN /ROY Ni MR a 07119 IW Sal I01O1L
SCARROr & PAI.1B$ INC. DATE: 06H BY :: DAC SCALE: 1 INCH .200 EEEr
811 COLORADO AVE. MARCH 5, 1993 CKD BY.• • JOB N0. 90181
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CLENWOOD SPRINGS COLORADO
A(It 0 b (4 ... fy itt I/7° ecehe 4d
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y67- 22.7-2_4
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BU Construction
Attn: Wayne Blanke
P.O. Box 2561
Aspen, Colorado 81612 Job No. 195 226
HEPWORTH- PAWLAK GEOTECHNICAL, INC.
TABLE I
HOLE NO. HOLE DEPTH LENGTH OF WATER DEPTH WATER DEPTH DROP IN AVERAGE
(INCHES) INTERVAL AT START OF AT END OF WATER PERCOLATION
(MIN) INTERVAL INTERVAL LEVEL RATE
(INCHES) (INCHES) (INCHES) (MIN. /INCH)
P -1 -2 88 15 71/2 5 21/2
refill 9 1/4 7 3/4 1 1/2
7 3/4 6 1/4 1 1/2
6 1/4 4 3/4 1 1/2
refill 63/4 51/2 11/4
5 1/2 3 3/4 1 3/4
refill 7 3/4 6 1/2 1 1/4
6 1/2 5 1 1/2
5 3 3/4 1 1/4 12
P -2 -2 63 15 9 1/2 7 3/4 1 3/4
7 3/4 6 1/4 1 1/2
61/4 51/4 1
refill 9 81/4 3/4
81/4 7 11/4
7 6 1/4 3/4
6 1/4 5 1/4 1
refill 91/4 81/2 3/4
8 1/2 7 3/4 3/4 20
P -3 -2 76 15 10 7 3
refill 11 9 1/4 1 3/4
9 1/4 7 3/4 1 1/2
refill 101/2 9 11/2
9 7 1/2 1 1/2
7 1/2 6 1/4 1 1/4
refill 101/2 9 1 1/2
9 7 1/2 1 1/2
12
7 1/7 _ R 1(4 1.
Note: Percolation holes were hand dug in the bottom of backhoe pits dug by others and soaked on May 9, 1995.
The test location is southwest of the residence excavation.
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