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Home My WebLink About02511 ro� • 4, 1 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2511 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81801 Phone (303) 945-8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Owner's Name Al & Jill Scott present Address 5325 CR 100, Carbondale Phone 963 -4640 System Location 5325 County Road 100, Carbondale Legal Description of Assessor's Parcel No. f 3 3y fl k cam_ / 8 'X7a'X'2 'S t SYSTEM DESIGN a 0 A .f { aidv " -T rit err' 4 ? < r {� ¢ -c o o -d i i i p +� di D en/ ✓ y 9 � A , its O Septic Tank Capacity ( anon) Other /emu- a l5 f, Percolation Rate (minutes/inch) Number of Bedrooms (or other) 4 Required Absorption Area • See Attached Special Setback Requirements: r 4 jj Date / / - 7 - 7 r ' Inspector / �/�l cam -CA J . t -U ��° FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer 0444 (`oDd Septic Tank Capacity. /'S 0 Septic Tank Manufacturer or Trade Name e41 Septic Tank Access within 8" of surface v E5 Absorption Area gc>6 </ Absorption Area Type and /or Manufacturer or Trade Name g i/ 44 e t l2- g Arts G0 z A ✓F /i Adequate compliance with County and State regulations/requirements UE Other • Date / /- �� ` 9 s Inspector r -. _ ' � 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. 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 off ice 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 jail or both). White • APPLICANT Yellow - DEPARTMENT • INDIVIDUAL SEWAGE DISPOSAL SYS'T'EM APPLICATION OWNER Pr(JA-/)J \`l tC c7 T ADDRESS aC c1(( 'S oo CgR(2NT aIONE 170 4 3 3 n CONTRACTOR ..m. - ADDRESS f 3 If a L406 6- PHONE c17O 9 YS - voT 32P - 33x 3 PERMIT REQUEST FOR (y NEW INSTALLATION ( ) ALTERATION ( ) REPAIR Attach separate sheets or report showing entire area with respect to surrounding areas, topography ofarea, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4). LOCATION OF PROPOSED FACILITY: tie COUNTY Near what City or Town C z� � e.o& Size of Lot #t Ai= Legal Description or Address / .tt T g-Sri c (rtC,_cc- ?A-A) cif 5 cry 42-0 ( c r4 (W WASTES TYPE: ()4 DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE DUILANG OR SERVICE TYPE: ( Number of Bedrooms 14'�T71 r*/) Gtob.. , } Number of Persons ( ) Garbage Grinder (X Automatic Washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (X) WELL ( ) SPITING ( ) STREAM Olt CREEK Give depth of all wells within 180 feet of system: a ):1-42 ' rg1,� SY cf If supplied by Community Water, give name of supplier GROUND CONDITIONS; Depth to bedrock: Depth to first Ground Water Table Percent Ground Slope ( o/ DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to community system? ( ) YES (X) NO TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: OG 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 Olt PIT ( ) EVAPOTRANSPIRATION QXj UNDERGROUND DISPERSAL, ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER- DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE ? /V 0 2 s PERCOLATION 1'ESI' RESULTS; (To be completed by Registered Professional Engineer) Minutes per inch in hole No. I 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: LferW 0 K 1 (._ — 7T. € I - 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 terns 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 dgpartnient of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any pennit granted based upon said application and in legal action for perjury as provided by law. Sn; a Alk. / Date V3 — Z i 0 "— Cj` P11 �7' ri t ;�, AN ACCURATE MAP TO YOUR PROPERTY!! I. or 3 r r , HEPWORTH- PAWLAK GEOTECHNICAL, INC. 5020 Road 154 Glenwood Springs, CO 81601 November 7, 1995 Fax 970 945 -8454 Phone 970 945 -7988 Yost Construction Attn: Jeff Yost 995 Brush Creek Lane Glenwood Springs, Colorado 81601 Job No. 195 498 Subject: Percolation Testing, 5325 County Road 100, Garfield County, Colorado. Dear Mr. Yost: As requested by you, Hepworth - Pawlak Geotechnical, Inc. conducted percolation testing at the subject site. The study was conducted in accordance with our agreement for geotechnical engineering services to Yost Construction dated October 25, 1995. Three percolation test holes were excavated prior to our arrival at the subject site. The percolation tests were performed in hand dug holes within backhoe pits. The holes were soaked on October 30, 1995 and the tests performed on October 31, 1995. The profile pit had not been dug at the time of our site work. The percolation test results are presented in Table I. The rates of percolation varied in the test holes between 5 and 60 minutes per inch. The variable rates appear to be due to differing soil conditions but based on our experience we expect a conventional infiltration disposal system will be feasible. If you have any questions or if we may be of further assistance, please call our office. Sincerely, I P ORTH PAWLAK G TECHNICAL, INC. Jo y Z. Ajamson, Jr., P. . R viewed By: , / /S /41 ST >9` �y ' ∎`i • Steven L. Pawlak, di 1 7 2 2 • O JZA /ro l '' t r T • s /ONAI ��'� r o ,' ' , T� OF ... c oy Attachment / •• • 4 HEPWORTH - PAWLAK GEOTECHNICAL, INC. TABLE I PERCOLATION TEST RESULTS JOB NO. 195 498 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 44 15 8 7 3/4 1/4 7 3/4 7 1/2 1/4 7 1/2 7 1/4 1/4 71/4 7 1/4 7 6 3/4 1/4 60 6 3/4 6 1/2 1/4 P -2 50 15 8 7 1 refill 9 8 1 8 7 1 refill 8 3/4 7 3/4 1 7 3/4 7 3/4 20 refill 8 1/2 7 3/4 3/4 P -3 52 15 10 51/2 41/2 refill 10 3/4 6 1/4 4 1/2 refill 12 7 3/4 4 1/4 refill 11 3/4 8 1/4 3 1/2 refill 12 8 1/4 3 3/4 refill 11 81/4 23/4 5 / S" H . 3 =2 8:3 Notes: 4ve /,46e r--i2n /'2M as' nom ,, 1. Holes were hand dug in bottom of backhoe pits and soaked on October 30, 1995. 2. Percolation tests were conducted on October 31, 1995. Holes were not frozen prior to testing. 3. Test holes were located between 40 and 80 feet directly west of the proposed addition.