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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 4 2J 1
108 Eighth Street, Suite 201 Assessor's Parcel No.
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY I
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Owner's Name 1f' t t I r r 6 r r—L4resse�nt Addressr4q 4o 6O0 Phone 5 7-7-5
System Location l./T". ov J r I' t CAUTo
This does not constitute
a building or use permit.
Legal Description of Assessor's Parcel No
SYSTEM DESIGN
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/i ch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback Requirements:
Date
In
ecto
FINAL SYSTEM INSPECTION AND APPRO L (a. ins =11e
Call for Inspection (24 hours notice) Before Co eri g Ins •dation
System Installer
Septic Tank Capacity
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other
Date Inspector
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 jail or both).
White - APPLICANT Yellow - DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER T1—) n 4s 71.>1.4-r.
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ADDRESS Ii c{ ui °t C 1Z 3 � pfr cA e- Co PHONE
CONTRACTOR sp-.rry
ADDRESS PHONE
PERMIT REQUEST FOR 9 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 9 ,Acis.• Size of Lot 3 5—Pic-AC?
Legal Description or Address &°T (, • E 2SeCf -0_3 T g , Q TC GO
WASTES TYPE: DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER -DESCRIBE
BUILDING OR SERVICE TYPE:
Number of Bedrooms Number of Persons
14 Garbage Grinder (S(Automatic Washer ('S 'Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (4 WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 3 ,-n (cs
Was an effort made to connect to the Community System?
A site plan is required to be submitted that indicates the following MINIMUM distances:
Leach Field to Well: 3 100 feet
Septic Tank to Well: )"' 0 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System (septic tank & disposal field) to Property Lines:. 10 feet
YOUR INDTVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
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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:
) 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 depai talent 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
Date 017 /DA
PLEASE DRAW AE'ACCURATE MAP TO YOUR PROPERTY!!
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PERCOLATION TESTS
The successful operation of your septic system depends on the rate the soil in which your leach field will be installed
will accept water. THIS IS CRITICAL. The rate of absorption is called the percolation rate and it determines the size
of the leach field needed for a particular flow of sewage and in some cases even determines the feasibility of the
installation of a septic tank and leach field system. PERCOLATION TEST MUST BE DONE AT THE GROUND
DEPTH WHERE ABSORPTION WILL TAKE PLACE. STANDARD SEEPAGE BEDS (LEACH FIELDS) ARE
INSTALLED THREE FEET DEEP, SO THE PERCOLATION HOLES ARE DUG FOUR FEET DEEP, AT LEAST
20 FEET APART, IN A TRIANGLE SHAPE. THE PERCOLATION TEST IS DONE IN THE BOTTOM ONE (1)
FOOT OF THE HOLE:
'Dnc^f urLl �
8" — IA"
BACK I4oe. 14 Le
L i 1 W4 r. 1
A posthole digger, auger or backhoe can be used to dig the percolation test holes. If a back hoe is used, dig the back
hoe hole three (3) feet deep, with a bite for steps, and put a test hole one (1) foot deep and 8 to 12 inches in diameter in
the bottom. Installation of absorption areas (i.e. drywells) deeper than three (3) feet require the permission of the
Environmental Health Department.
Saturation with water will affect the percolation rate, and since the system will be expected to operate when the soil is
saturated with water, THE HOLES MUST BE FILLED WITH WATER AT LEAST EIGHT (8) HOURS BEFORE
THE TEST AND ALLOWED TO STAND. More water will be needed to perform the percolation test, so AT LEAST
FIVE (5) GALLONS OF WATER PER HOLE SHOULD BE ON HAND WHEN THE TEST IS PERFORMED.
AN EIGHT (8) FOOT PROFILE HOLE IN THE LEACH FIELD AREA IS REQUIRED IN THE STATE OF
COLORADO TO DETERMINE THE PROXIMITY OF GROUND WATER AND BEDROCK. (One soil profile hole
shall be drilled or dug to provide observation of the soil profile of the area of the soil absorption system. The hole shall
be prepared at least eight (8) feet deep. The hole may be terminated when groundwater or bedrock is encountered. The
hole shall be prepared in such a way as to provide identification of the soil profile four (4) feet below the bottom of the
soil absorption system).
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(FOR APPLICANT'S INFORMATION)
PERCOLATION TESTS FOR DRY WELLS (SEEPAGE PITS) ARE PERFORMED AT THE LEVEL OF THE
BOTTOM OF THE PIT (USUALLY 10 FEED.
Citau,id LeveL
If you call for a percolation test or inspection and for some reason are not ready when the time comes, please call us
before 4:00 p.m. at 945-8212 to cancel the appointment.
THANK YOU FOR YOUR COOPERATION.
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RECOMMENDED MINIMUM REQUIREMENTS FOR
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
Before construction is started, the Inspector must be contacted for approval and detailed information concerning the
proposed disposal system. Higher standards than those which follow may be required in individual cases to assure
attainment of the objective. Those objectives are to locate, construct and maintain individual sewage disposal systems
in such a manner that existing or contemplated water supplies will not become contaminated and so that sewage will
not overflow the ground surface and result in a nuisance or health hazard.
1. LIQUID CAPACITY OF TANK (GALLONS)
(Provides for use of garbage grinder, automatic clothes washers and other water using household appliances).
Recommended Minimum
Number of Bedrooms Tank Capacity
2 or less 750 gallons
3 or less 1,000 gallons
4 1,250 gallons
For each additional bedroom, add 250 gallons
2. MINIMUM LEACHING AREA OF DISPOSAL FIELD ABSORPTION AREA REQUIREMENTS FOR
INDIVIDUAL RESIDENCES
Percolation Rate
(time required for
water to fall one
inch, in minutes)
Required Absorption
Area, in sq. ft.
per bedroom
(b) standard trench
(c) seepage beds &
(d) seepage pits
Percolation Rate
(time required for
water to fall one
inch, in minutes)
*1 or less
*2
*3
*4
*5
10
15
30(e)..
45(e)..
60 (e), (f)
*(See Below)
Required Absorption
Area, in sq. ft.
per bedroom
(b) standard trench
(c) seepage beds &
(d) seepage pits
228
279
395
483
558
*Percolation rates faster than five (5) minutes per inch or slower than sixty (60) minutes per inch require
engineered system and/or Board of Health approval.
(a)
(b)
It is desirable to provide sufficient land area for entire new absorption system if needed in future.
In every case, sufficient land area should be provided for the number of bedrooms (minimum of 2) that can
reasonably be anticipated, including the unfinished space available for conversion as additional bedrooms.
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Absorption area is figured as trench -bottom area and includes a statistical allowance for vertical sidewall area.
(c) Absorption area for seepage pits is figured as effective sidewall area beneath the inlet.
(d) Unsuitable for seepage pits if over thirty.
(e, f) Unsuitable for absorption system if over sixty.
Dwelling on less than two acres, areas of high water tables, or areas with a percolation test rate faster than 1" in 5
minutes must have alternative sewage facilities, i.e., central collection, holding tanks, individual treatment, etc.
EXCEPTION: Absorption areas may be allowed with percolation rates faster than one (1) inch in five (5) minutes
provided the soil is a sandy texture and no water table problems are encountered.
1. Maximum length of drainage line: 100 linear feet
2. Minimum width of drainage trench: 18 inches
3. Minimum spacing between trenches or pipes: 6 feet
4. Maximum grade of drainage lines: As level as possible
5. Minimum depth rock under drain PVC: 6" under PVC, 2" over PVC
6. Minimum depth of cover over distribution lines: 12 inches
7. Maximum depth of cover over distribution lines: Variable
8. Minimum grade of house sewer: 1/8 to 1/4" per linear ft.
9. Minimum distance of sewage disposal system
from dwelling: 20 feet
10. Minimum distance of septic tank from dwelling: 5 feet
11. Minimum distance of' leaching area to a well: 100 feet
12. Minimum distance of septic tank to a well: 50 feet
13. Minimum distance of leaching area to a stream
or water course: 50 feet
14. Minimum distance from septic tank and disposal
field to property lines: 10 feet for drywell
10 feet for leach field
15. Minimum sewer pipe and distribution pipe: 4 inch diameter
Septic construction should be of concrete, concrete block or of a material that will resist deterioration and which can be
made reasonable watertight.
Acceptable drain field pipe materials include plastic, terra cotta or concrete. If the house sewer line is longer than 10
feet between house and septic tank, a clean-out Y should be installed as near as practical to the house.
Septic tanks should be inspected once a year and cleaned when necessary. Cleaning is recommended when space
between the scum accumulation and sludge residue on the tank bottom is less than eighteen (18) inches.
The Department recommends pumping a septic tank once every four (4) years when a yearly inspection by the owner is
not practical.
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