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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2760
109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81601
Phone (303) 945 -8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
PROPERTY
Dan & Eva Baharav 963 - 9659
Owner's Name Present Address Phone_
2370 County Road 112, Carbondale
System Location
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
(0 0 0 Septic Tank Capacity (gallon) Other
3
Percolation Rate (minutes /inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback ( R R R . equirements:
Date ( Inspector.
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours n Before Covering Installation /�
System Installer v ( C 0 C D 0 ' ` ' \ ( $ ^ Septic Tank Capacity v D . / �� 7 OOP et- A N e 9/ I ( [ � ( F i y C `r i∎ A l (.> a(
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface ES
Absorption Area I '"" .cf r^ �t
Absorption Area Type and /or Manufacturer or Trade Name I )' /- ! C Tali a N T 0n f
Adequate compliance with County and State regulations /requirements \i S
Other ,
Date 9 Inspector en.— e_.
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 — 6
months in )all or both).
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White - APPLICANT Yellow - DEPARTMENT _ —
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER _ 044_ -.� kAA &tf
ADDRESS . LO7 1 6/414-"Art-4-0 Sc A D PHONE ( 16) ` 1 6 S
CONTRACTOR 5m 15r c 2 (Q�Vtl - c/ <c l - �y
ADDRESS 1 5 5 Z CP4' t' R(6,a PHONE 963 - 9yTV
PERMIT REQUEST FOR ('KNEW 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.
Near what City of Town (.A.Rr ed"4 -tt-E Size of Lot 3• 15 5A - G
Legal Description or Address Gore 4 - r444..4JSue0
WASTES TYPE: p<1 DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: £ s,t
Number of Bedrooms 3 Number of Persons _ 2
4 Garbage Grinder Y " Automatic Washer (»Dishwasher
SOIJRCE AND TYPE OF WATER SUPPLY: WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: / 44/ Lam.5
Was an effort made to connect to the Community System? l✓S
I. • • ,l;n i r• i gym' • s i t ', ci h filly in. MI M Jli 'i <n • •
Leach Field to Well: 100 feet
Septic Tank to Well: 50 feet ✓
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet -'
Septic System to Property Lines: 10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED
WITHOUT A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table .
Percent Ground Slope Ze
2
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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:
(4 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? N c
PERCOLATION TEST RFSTILTS; (To be completed by Registered Professional Engineer, if the Engineer does
the Percolation Test)
Minutes per inch in hole No. 1 Minutes per inch in hole NO. 3
Minutes per inch in hole No. 2 Minutes per inch in hole NO.
Name address an j telephone ofRPE who made soil absorption tests: 16 /56 m4 c 4 y !/Alp rase &s 6. (,3, , c (Ida 2 - S %; - ?ST47
Name, address and telephone of RPE responsible for design of the system. Sass. c
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 purposed 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
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 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
permit granted based upon said application and in legal action for perjury as provided by law.
Signed ca . Date 41 7(77
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
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TIMBERLINE IENG IE I_
lay 0 9 1991' VIII
STRUCTURAL /CIVIL. ENGINEERING, CONTRACTING *CERTEFIIED ENERGY ISESIIGN PROFESSIONAL
May 6, 1997
Garfield County Building Department
109 8th Street, Suite 303
Glenwood Springs, CO 81601
Re: Leach Field Design
Baharav Resisdenc
2370 CR 112
Garfield County, Colorado
Dear Mr Owens:
The location of the infiltrator bed and the closest well to the bed location are shown on the
drawing submitted with the permit. Three percolation test holes were excavated and a 1' hole
dug at the bottom for testing. The results are as follows.
TANK SIZING
Bedrooms Persons/BR Gal/day/person Total GPD Design Flow
3 2 75 450 675
A 1000 gallon septic tank is required.
J3ED SIZING Area = Q / 5 x Sqrt(T)
Q =675
T = 22.7
Area = 707 square feet.
40% Reduction for infiltrator bed = 707 x 0.6 = 424 square feet.
A total of 28 infiltrator units is required.
If you have any questions regarding this report please call us at 970 - 963 -9869.
VDU R .., .
Sincere i , A. P µ it:
aza i O 5 /65 7 0
David A. Powell, PE %,
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DAB POWELL, PE. PHONE / FAX
P.O. BOX 631
CARBONDALIE, CO. 81623 (970) 963 -9869