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• GARFIELD COU BUILDING AND SANITATION DEPARTMENT Permit N2 1 0 7 4 ,'d
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1 r • 109 8th Street Suite 303 Assessor's Parcel No.
f '4 Glenwood Springs, Colorado 81601 •
-.. Phone (303) 945 -8212 •
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St-0e This does not constitute
"t INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. i, '
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• 1 Owner's Name r t "^RS• 1 1 ) $ i W S @ . Present Address 9 .0 Etr1105 C( ---rek ) Co gen q ? C °.g a
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it System Location C (A i s J F
F 4 Legal Description of Assessor's Parcel No. (,I f Ca 11e COP " [ r `& • •k t 1 S) ? r
, , ; SYSTEM DESIGN 1 4 I FGsn+ Exe n n J i , f
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t .' f n co )11,A: Septic Tank Capacity (gallon) Other r
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y i �. 20 Percolation Rate (minutes /inch) Number of Bedrooms (or other) $. R i i ,
/121 Y -Zocis Lrt' ,,zt.0 f . d
1 y Required Absorption Area - See Attached 30 c C rear
; 1 54)3 ^9.`* nr ~ d•- r¢j-. ? h' u +; � — ' i Special Setback Requirements: 4,74' zi PT 3lo L. Putt xi C,.,.,' / 1 t.1 - T2E� `
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i d Date / ) P 1 ' — Inspector &• S r u..)At. : 2 d
i FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
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f f Call for Inspection (24 hours notice) Before Covering Installation , d
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, ` , S ystem Installer C,..) r k
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Y Sept Tank Capacity • - 1
Septic Tank Manufacturer or Trade Name CO e -c- Pal
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Septic Tank Access within 8" of surface - ' r
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Absorption Area T (
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l` Absorption Area Type and /or Manufacturer or Trade Name 36 3 G` L; t 'f t PG* n - f) r
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Adequate compliance with County and State regulations/requirements f
Other .:..�. a.•_ _ 'J.7 �}-
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1' t Date / Q ' ( �O� Inspector ' � _ f , ! i I I t • f '
t 6 RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE t• 1
1 •CONDITIONS: 1
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. l.
( 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con -
i . nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a rt l
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 r
r s variation from the terms or specifications contained in the application of permit commits a Class 1, Petty Offense (4500.00 fine — 6 ! 1
months In )all or both). • ,
ty
„ White - APPLICANT Vellow - DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER 4v' f S (V . not ( /I s c
ADDRESS 3, '3 rules � P // Co..47 a 113 PHONE c id 13 - 80'3 7
CONTRACTOR, aame4 W. Ai-aka c
ADDRESS ?o, ( x /o i FJ ehP/,CC> `12I6 PHONE 9a - S7
PERMIT REQUEST FOR 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:
Near what City of Town Ohm wood 5690 hi 5 Size of Lot cc CD - 6 act e3
Legal Description or Address
WASTES TYPE: DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: Lori 5Vied o ^� e
Number of Bedrooms / J Number of Persons 9
( ) Garbage Grinder ( ) Automatic Washer 0A Dishwasher
SOT JRCP. AND TYPE OF WATER SI JPPLY 6 WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: ri I le 5
Was an effort made to connect to the Community System? ACS
A site plan is required to be submitted that indicates the following MINIMLJM distances:
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 INDIVIDLJAI, SEWAGE DISPOSAL SYSTEM PERMIT WIIJ. NOT BE ISSUED
WITHOUT A SITE PLAN.
CIRO' JND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
2
- ' TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(74 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:
( )9 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?
pERCOT .ATION TEST REST IT TS: (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 and telephone of RPE who made soil absorption tests:
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 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 : anted based upon said application • id in legal action for perjury as provided by law.
I
Signe �� � � I/, ��. , s.�1. Date /1 / 3 - 9 S
PLEA , RAW AN ACCURATE MAP YOUR PROPERTY!!
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• HEPWORTH- PAWLAK GEOTECHNICAL, INC. 5020 Road 154
• Glenwood Springs, CO 81601
Fax 970 945 -8454
Phone 970 945-7988
Jim Marshall Invoice No. 6587GS
P.O. Box 105 Job No. 198 703
El Jebel, Colorado 81628 October 23, 1998
INVOICE FOR PROFESSIONAL SERVICES
RE: PERCOLATION TEST RESULTS, PROPOSED RESIDENCE CATTLE
CREEK ROAD, 3.8 MILES FROM HIGHWAY 82, GARFIELD
COUNTY, COLORADO.
$ 350.00
Total Due $ 350.00
Thank you
<L7 g— k
Steven L. PPawlak, P.E.
/ro
Please pay from this invoice. Total due upon receipt. Interest charge of one and one -half percent
(11%) per month due after 30 days.
W 07'1
B • HEPWORTH- PAWLAK GEOTECHNICAL, INC. 5020 Road 154
Y .. Glenwood Springs, CO 81601
October 23, 1998 Fax 970945 -8454
Phone 970 945 -7988
Jim Marshall
P.O. Box 105
El Jebel, Colorado 81628 Job No. 198 703
Subject: Percolation Test Results, Proposed Residence, Cattle Creek Road, 3.8
Miles from Highway 82, Garfield County, Colorado
Dear Mr. Marshall:
As requested, percolation tests were conducted to evaluate the feasibility of an
infiltration septic disposal system at the subject site. The work was performed in
accordance with our agreement for services with you dated October 15, 1998.
One profile pit and three percolation holes had been dug in the proposed disposal area
prior to our arrival on October 15, 1998. The test holes (nominal 12 inch diameter by
12 inch deep) were hand dug at the bottom of shallow backhoe pits and were soaked
with water one day prior to testing. The soils exposed in the percolation holes are
similar to those exposed in the Profile Pit shown on Fig. 1 and consist of silty gravelly
sand with cobbles. No free water was observed to the profile pit depth of 8 feet.
We understand that the profile pit and percolation holes will be field located by the civil
engineer. The percolation test results are presented in Table I.
Based on the subsurface conditions encountered and the percolation test results, the
tested area should be suitable for a conventional infiltration septic disposal system.
If you have any questions or need further assistance, please call our office.
Sincerely,
HEPWORTH - PAWLAK GEOTECHNICAL, INC.
P
Steven L. Paw ' • , P. E.1 5 2 2 2 .7
IV el S90 1 s
SLP /ksm 1, JT • . NA
cc: Sopris Enginee r : Yancy Nichol
■
PROFILE
PIT 1
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LA- LL
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10 10—
LEGEND:
TOPSOIL; organic silty sand, slightly gravelly, loose, slightly moist, brown.
k SAND (SM); silty, gravelly. scattered cobbles, medium dense, slightly moist, reddish brown.
A
Disturbed bulk sample.
NOTES:
1. The exploratory pit was observed on October 15, 1998 and had been dug with o backhoe.
2. The lines between materials shown on the exploratory pit log represent the approximate
boundaries between material types and transitions may be gradual.
3. No free woter was observed in the pit.
Fluctuations in water level may occur with time.
HEPWORTH — PAWLAK
198 703 GEOTECHNICAL, INC. LOG OF EXPLORATORY PIT Fig. 1
• HEPWORTH - PAWLAK GEOTECHNICAL, INC.
TABLE I
PERCOLATION TEST RESULTS JOB NO. 198 703
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 53 15 181/2 15 31/2
15 12 3
12 9 3/4 2 1/4
9 3/4 8 1 3/4
8 6 1/2 1 1/2
6 1/2 5 1/2 1
5 1/2 4 3/4 3/4 20
P -2 40 15 12 1/2 10 1/2 2
10 1/2 9 1/4 1 1/4
9 1/4 8 %1 3/4
8 1/2 7 3/4 3/4
7 3/4 6 3/4 1
6 3/4 6 3/4
6 51/4 3/4 20
P -3 38 15 121/4 101/4 2
101/4 9 11/4
9 8 1
8 7 1
7 6 1/2 1/2
6 1/2 5 3/4 3/4
5 3/4 5 3/4 20
NOTE: Percolation holes were hand dug in bottom of backhoe pits and soaked on October 15, 1998. Percolation tests were
performed October 16, 1998.