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Home My WebLink About4377I I ·,,., .. - GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 201 Glenwood Springs, Coloradof 81601 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Phone (970) 945-8212 \ (" .. E· c-,~ .. -"" . ) ........, ·-·1 ' ' ..... __ /' ,' l -...._.,r ·-·' - Permit Assessor's Parcel No. This does not constitute a building or use permit. Owner's Name \~\~Di:' ( \.S I$\' VW!C \ Y\ Present Address L\&i, $~ · d, "\ 1"' ~\. ~-1\-\C. Phone '3(51 -L\ ·~ ~:_\- ( ,:iSS <.···\ (Y•<n ~ 'f' -~.I\\(~~ System Location-'---"""-=-=--''-'-'--"~"'""'-~'-'D"'-'---"'-.C..:.l-'-=---------------~---------- Legal Description of Assessor's Parcel No. 'Q\F \C (1r· SYSTEM DESIGN __ IL1 olL<OLOJ...L..__ Septic Tank Capacity (gallon) ______ Other q Percolation Rate (minutes/inch) Number of Bedro~!l)S\(~t other) (,,'WIll f\OJ\ ""\€ q Required Absorption Area-See Attached ' 31~0i\i tM yJU,vA 11 o'" .:<. \A be\\ Special Setback Requirements: ! o \.\J i-\ I'=> J..J ;D Date_-"l-'-'"'-'_-_1..:-i_-_b_oc:c~ _____ Inspector ---'N'-·.::..;:M"---'-l "'&'-\ -'-)1\_v:...'\-'Ji."'~""'A-'----------------- FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for inspection (24 hours notice) Before Covering Installation System Installer ,. ~UI\'.1 ,\.\,~·f·V.r,1 • o/~ 11:~ SeptiC Tank CapaCity l e• -~~\ '' (\ \\ h, Septic Tank Manufacturer or Trade Name _:..L----~----''-2··il:")*"Q"'~:.!l\-.c:.:::··:.;Oe:_' _______________ _ Septic Tank Access within 8" of surface ~..L.-----+-c~-'+'"'--''---""~--------------- 1)/· \ . '-·· · ... ····~ ,.(..)' u. ,., .~ \.fl" \J\Q.\\,· ··\ Absorption Area _. \. ,.~! .,_., \_ 1 \ •• • ' . I Absorption Area Type and/or Manufacturer or Trade Name _'·c:.·..,J~;!O\·'"'~.-J)r._ .c: 1 ""Y,-'\"').L, 4J,L·,,_,__~\.:.'~_,..'-'-'("'\,.o\·c.1 ·'-",f_/:__\c.-_'-\_,_\ .. __ _c\.l\_··_l_-'--__ ) ____ _ ... • .. Adequate compliance with County and State regulations/requireme~~s \\. 9J.Y ' ---------------------------------- Other __ ~------------~----------------------~--------~------------------------------- Date ___ C_\,_, ·_'-_\L.._,__,C'-1--\.,tLI ______ Inspector ___ '\+-.. "'.~'-'("'~'-'''-:,_{::..\.:.'----i-L:•'-'\\-'('"'-.-"("'(-'t'-~"--------------------- 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 i_n jail or both). Whi1e -APPLICANT Yellow-DEPARTMENT L------------------------ PERMIT REQUEST FOR ( ~EW 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 ofT own !\. i ~ k.. Size of Lot ,;z .'(; 7 IG ute s Legal Description or Address lo+ I I te .• f le c n::.e.k. c. 5 t a.+es I f:· I" !A.1 AJo ' ,.2_ WASTESTYPE: (vJ'DWELLING DgC?E; f1/I.€S:C<. :})(.( ) TRANSIENTUSE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ()OTHER-DESCRIBE ______________________________ __ BUILDINGORSERVICETYPE: ';If /(e~,cflev-c- Nurnber of Bedrooms '3 Number of Persons 2.. --------- (;;{Garbage Grinder ( 0'1\utomatic Washer ( y.{)ishwasher SOURCE AND TYPE OF WATER SUPPLY: (/)\\TELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: G<>tv1 lit>\uv<i-fy (;Jet1 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: __________________ _ Was an effort made to cormect to the Community System?--------------- A site plan is required to be submitted that indicates the following MINIMUM 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 (septic tank & disposal field) 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 ____ -'-------~--------~-------- 2 TYPE OF INDIVIDUAL SEW AGE DISPOSAL SYSTEM PROPOSED: ( >') SEPTIC TANK ( ) AERATION PLANT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) PIT PRIVY ( ) INCINERATION TOILET ( ) CHEMICAL TOILET( ) OTHER-DESCRIBE FINAL DISPOSAL BY: ( Vf ABSORPTION TRENCH, BED OR PIT ( ) UNDERGROUND DISPERSAL ( ) ABOVE GROUND DISPERSAL ( ) VAULT ( ) RECYCLING,POTABLE USE ( ) RECYCLING, OTHER USE ( ) EVAPOTRANSPIRATION ( ) SAND FILTER ( ) WASTEWATER POND ( ) OTHER-DESCRIBE·------------------------ WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STA TE?--"iY.'-"o'--- PERCOLA TION TESTRESUL 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 ofRPE who made soil absorption tests:-------------- Name, address and telephone ofRPE responsible for design of the system:-------'---- Applicant acknowledges that the completeness of the application is conditional upon su<',_, "' • v and additional tests and reports as may be required by the local health department to be _v icant or by the local health department for purposed of the evaluation of the applicatim r-it is subject to such terms and conditions as deemed necessary to insure compliance ~ de, information and reports submitted herewith and required to be submitted by the app! ~ to be true and correct to the best of my knowledge and belief and are designed to be rel~--~ )f health in evaluating the same for purposes of issuing the permit applied for herein ~ -. ~ .. y falsification or misrepresentation may result in the denial of the application or revocall , _,,.HE granted based upon said application and in legal action for peijury as provided by law. 0tsi~f!~ iiM L . R~ lk~liirf'll!tiWl~'J;;J! o ·-; J. -6 7 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 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). Number of Bedrooms 2 or less 3 or less 4 .......... . For each additional bedroom, add Recommended Minimum Tank Capacity 750 gallons 1,000 gallons 1 ,250 gallons 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) *1 or less *2 ............. . *3 ............. . *4 .............. . *5 ............. . 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) 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) It is desirable to provide sufficient land area for entire new absorption system if needed in future. (b) In every case, sufficient land area should be provided for the number of bedrooms (minimum of2) that can reasonably be anticipated, including the unfinished space available for conversion as additional bedrooms. 6 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 I" 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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Maximum length of drainage line: Minimum width of drainage trench: Minimum spacing between trenches or pipes: Maximum grade of drainage lines: Minimum depth rock under drain PVC: Minimum depth of cover over distribution lines: Maximum depth of cover over distribution lines: Minimum grade of house sewer: Minimum distance of sewage disposal system from dwelling: Minimum distance of septic tank from dwelling: Minimum distance of!eaching area to a well: Minimum distance of septic tank to a well: Minimum distance ofleaching area to a stream or water course: Minimum distance from septic tank and disposal field to property lines: Minimum sewer pipe and distribution pipe: 100 linear feet 18 inches 6 feet As level as possible 6" under PVC, 2" over PVC 12 inches Variable 1/8 to 1/4" per linear ft. 20 feet 5 feet 100 feet 50 feet 50 feet 10 feet for drywell 10 feet for leach field 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. 7 ~ Designate North Arrow Your Neighbor's Name & Address 7 . 0'1: z.:s iY\.eSJ De.. ~-;-.q~ ,CD 'g\ to<::.-0 Is~ u E Your Plot -Shape to Fit (No Scale) ~ j -- l "~-.I tJ '?; '-' :;. ' >&L ); \\. \_-,..., . ...-,..,.._ -· ---------···-----~~------'-----r ~\t~~ I ,._ ··--····· ···-·----~ a/.l.i/eru Clr septic tank & system, detached garages, and drivewa . I If a change oflocation is necessary, you must submit a corrected dr wing, before a Certificate of Occupation will be issued. \ County Road (Note the Road Number and Name) ' .(L\ \)e... eric c:\wpwin60\wpdocs\plotJoc vi {_3A) ' Your Neighbor's Name & Address Ja~ D. 4- Kav-cl"-~ . CJcJ l+ers ~ Lf S 11\.e ~ bt<. tzl ~1-c J~.D ~ll,;,SO VI