HomeMy WebLinkAbout03293 T)CPE QF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( EPTIC TANK , ( ) AERATION PLANT ( ) VAULT
( e ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE
( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE
FIN ISPOSAL BY:
(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?
PERCOLATION TEST RESULTS: (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 granted based
upon said application and in legal action for perjury as provided by law.
Signed Kv ' Z 7 Date 42/2. ;/9 P
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
3
P.O. Box 1908 / /,\ (970) 945-5700
Cooper Ave. (970) 945 -1253 Fax
Glenwood springs,
CO 81602 Z4NC4NELL4 41113 455004TE5, INC.
ENGINEERING CONSULTi4NT5
June 12, 2000 RECEIVED JUN 1 3 2008
Garfield County
Building and Planning Department
109 8 Street, Suite 303
Glenwood Springs, CO 81601
RE: John Saunders ISDS, Teller Springs
Dear Building and Planning:
Zancanella and Associates, Inc. has been contracted to design the ISDS for the John
Saunders barn apartment at 0126 Lariat Lane in the Teller Springs Subdivision. We
inspected the system prior to burial on May 11, 2000 and found it to have been constructed
according to the attached design.
If you have any questions, please call our office at (970) 945 -5700.
Very truly yours,
Zancanella & Associates, Inc.
Thomas A. Zancanella, P.E.
N :\20000\20715 John Saunders \GarCounty.wpd