HomeMy WebLinkAbout02631 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2631
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 Frank Sedillo /Karen Demplssynt Address 740 Minter G1 enwnod 7 Phone 945 -7737
System Location 0113 Rio Seen Rnad Riprrn Plnynn, Tint 6, Silt
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
4 000 Septic Tank Capacity (gallon) Other
� • 0 () Percolation Rate (minutes /inch) Number of Bedrooms (or other) 9
Required Absorption Area - coo Augrh&d
$/f'. I flO /-I 3,- ( eFcti sa— (2')'7"or.t'.f'
4;07 ]' -0 ,.fri)tK M 0 R cwQ it) - p 27 t-az
Special Setback Requirements:
/�
y 1
Date �/� /`7 /, Inspector 4 ?.4. erfek 4, R47., „arselv-r-Q 10,
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer Q /d/Lk
Septic Tank Capacity / (no
Septic Tank Manufacturer or Trade Name Name _ear
znArl
Septic Tank Access within 8" of surface S-'F.s
Absorption Area 6;
Absorption Area Type and /or Manufacturer or Trade Name S 4) 4 U N r5 1 /!11 i1rPis
Adequate compliance with County and State regulations /requirements
Other
•
Date It 1).-f4 Inspector /�! ✓ 7 (J s rlar +O
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 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 ($500.00 fine —8
months in jail or both).
q v; 765-7 White - APPLICANT Yellow - DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAI.SYSTEM_APPLICATION
OWNER FRAM SeoiLLo 4- koAe Demi'sey
ADDRESS PHONE 795
CONTRACTOR To Q RANIJL
ADDRtSSio, Box 536 Sri.T co, 8/45a PHONE (770)
PERMIT REQUEST FOR (y) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area,
habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY_ COUNTY GARF)e
Near what City or Town- - -Sall _-------- _-- _.-- __ - -._ Size of Lot _li2/__i9S$e
Legal Description or Address Sec iow 0 Z%vA' SAN 6 Sa 1 rr - 02 w - _ _
4 DR JEL r iiAC M eg W /RN
WAS'T'ES TYPE: c;.‹) DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTItIAI. ( ) NON - DOMESTIC WASTES
( ) OTHER- DESCRIBE_ _
BUILDING OK SERVICE TYPE:
Number of' Iledrooins _ eepRonni Number of Persons e 2
( ) Garbage Grinder Automatic Washer (>0 Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (X) WELL ( ) SPRING ( ) STREAM OR CREEK
Give depth of all wells within 180 feet of system:
If supplied by Community Water, give name of supplier
GROUND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water "fable
Percent Ground Slope
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 4 mites OR SO
Was an effort made to connect to community system? ( ) YES (X) NO
TYPE OF INDIVIDIJAI. 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:
OQ ABSORPTION TRENCII, BET) OR PIT ( ) EVAPOTRANSPIRATION
( ) UNDERGROUND DISPERSAL. ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER-DESCRIBE
WILL. EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?
2
VERC M,A'I'ION RESULTS; ("1'o be completed by Registered Professional Engineer)
Minutes per inch in Bole No. 1 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:
Nance, address and telephone ofRPE 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 fi by the
applicant or by the Iocal (health department Ibr purposes of the evaluation of the application; and the issuance of the
permit 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 repass 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 same for 'imposes 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 provided by law.
Signed - ' / ._"� Date 3 -a s- /996
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!'
3
SIERRA PINYON SUBDIVISION
Percolation Test Report
Test No. 1
Location: Lot 6, Sierra Pinyon Subdivision
Test Hole: 2.3 ft to 3.5 ft below surface
Elapsed Time: 128 minutes
Change in Water Level: 0.54 ft • 6.5 in
p
Percolation Rate: 19.7 minutes /inch = 2 n''� - �^`��'1
Soil Profile:
Depth Below Surface Description
0.0 ft to 1.5 ft Medium brown silty clay topsoil in root zone of
vegetation
1.5 ft to 4.1 ft Light brown and grey mottled silty clay subsoil
4.1 ft to 6.6 ft Light to medium grey sandy siltstone, loosely
consolidated; can be dug with hoe.
No bedrock or water table was encountered in the soil profile hole.
Engineer's Certificate
I hereby certify that this percolation test was conducted by me on March '.2,
1995. and that the reported percolation rates and soil profiles are accurite and
represent conditions at the test location. I further certify that the holes were
presoaked for at least 24 hours prior to the observations.
•
so.
Datr 4 ,P .1 /49s __, rl� �.
' Herbert A. ttsch r. E -L.S. 6826
:: 68 2• : t
di °i
OF CO'
Job No. 94 -063
Sierra Pinyon Subdivision
