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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner's Name L~ell:5: !l ebw Present Address I \o€>3 Cf ~d-o-tlf le,
System Location 1\363 C'CZ>dO-~\FlC...
5P~ \ObY I
Permit 4367
Assessor's Parcel No.
This does not constitute
a building or use permit.
Legal Description of Assessor's Parcel No. a(L.J_~Lt:,_::r_,_-_luDuLI__,_-()'""""'D-~D..Lt\:>,b,_ _________________ _
SYSTEM DESIGN
--------Septic Tank Capacity (gallon) ______ Other
-------Percolation Rate {minutes/inch) Number of Bedrooms (or other) _____ _
Required Absorption Area ~ See Attached
Special Setback Requirements:
Date _____________ Inspector _______________________________ __
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
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 i
Date kf/Y{o(l Inspector ~ v~ Ll. (% e e: ,•
5 J .;lJ-/o<fRETAI~ w1r R<:CEIPT REcoRDs AT coNsTRucTioN siTE C..; Vc. 0 ;:1 · .
*CONDITION{ I ' ///).&-]{) . ~~-...
1. All installation must comp with all requir;mentslfthe 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 '" jail or both).
White· APPLICANT Yellow. DEPARTMENT
INDIVIDUAL SEW AGE DISPOSAL SYSTEM APPLICATION
oWNER :i)eb•o 4 Lydl~ .
ADDRESS .f/8/e9 ~;.?d. 3d0 B£te, ro
CONTRACTOR~oroc.,s
ADDREssJdiJS Nti>y &i ;;4fjr-atvc~, fd;CO
PHONE 9'7tJ~6:J5('C".J3;);)..
8fKJ·-M-tt -'~5 t.o
PHONE'/10--,7?{45 -@39
PERMIT REQUEST FOR (Xi 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 ofT own 'RI¥ I <2--Size of Lot o. c~ 8 A ue
Legal Description or Address t 18~, ;') 0-±~1-:t?,d .{)~) 0
WASTES TYPE: • ~ DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER-DESCRIBE _____________________________ ___
BUILDING OR SERVICE TYPE:;£JJ.JI~~)'.LJ01+' [r:_t?--t£8-'CIL'_. uO_J_Juif.k!cl_· -------------
Number of Bedrooms _____ _,, ""--------------N.umber of Persons ___,!i ___ _
~ Garbage Grinder rxJ Automatic Washer (><)Dishwasher
SOURCEANDTYPEOFWATERSUPPLY: ( )WELL ( )SPRING ( )STREAMORCREEK
If supplied by Community Water, give name of supplier: ert/' VK-~fcf&~ (/.IF 1-G
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:-!0"-5.L:fl6\-'11'-"'' €~·f~-----------
Was an effort made to connect to the Community System? _{j"'f1~:.JPi/J!.J---------------
A site plan is required to be submitted that indicates the follbwing 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:
M 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
tfl UNDERGROUND DISPERSAL ( ) SAND FILTER
( ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER-DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? A)O
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, addre.ss 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 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,
infonnation 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 pem1it applied for herein. I further understand that any
falsification or misrepresentation may result in the denial of the application or revocation of any pennit granted based
""'" '"id '&. oo6oo md io ""') '"""' foe pojmy M pw~ded by low. /.
Signed , . Date (}f}//O!JJ'}
r ~~ PLEASE DRAW AN ACCUR4' E MAP TO YOUR PROPERTY!!
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Designate North Arrow ~ ..
Your Neighbor's
Name & Address
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Locate well, all streams, irrigation ditchs, and any water courses. Draw in your house,
septic tank & system, detached garages, and driveway.
If a change oflocation is necessary, you must submit a corrected drawing, before a
Certificate of Occupation will be issued.
County Road (Note the Road Number and Name)
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Your Neighbor's
Name & Address
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from: I-70 EXIT 90 to: 11863 CTY RD 320 RIFLE,C081650-Google Maps Page 1 of2
http://maps.google.com/maps?q=Rifle,+CO,+United+States+of+America&sa=X&oi=map... 9/10/2007
Lyells Individual Sewage Disposal System
11863 Cnty Rd 320, Rifle, CO
Given:
Req'd:
Solution:
Code
Single Family Home
[]) Bedrooms
[J] Laundry
[J] Garbage Disposal
@2] Minute per Inch Percolation Rate (t)
Septic System Design
Colorado Dept. of Public Health and Envrionment
Vance V King, P
CIVCO Engineering, Inc.
A ril4, 2008
Guidelines for Individual Sewage Disposal Systems (5 CCR 1003-6)
Septic Tank
3 Bedrooms 1000 0 Ibn
Absorption Area
Maximum Daily Flow:
Q = 1.5x( 3 8edrooms)x(2 Persons/Bedroom)x(75 gpd/person) =
Minimum Absorption Area: A = (Q/5)x(tf5 =
Laundry Increase: 0.4X(A) =
Garbage Disposal Increase:
0.2x(A) =
Number of Quick 4 Units
Ao, = 9.2 sq. ft.
182 units
1 of 1
675 gpd
1046 sq. ft.
418 sq. ft.
209 sg. ft.
1673 sq. ft.
SYSTEM SCHEMATIC
DlSTR lBUTION
BOX 1:'--:/:::::
~
\\ ~ 0' -[' 6'
IN, T MIN\ ~~ '--H-O_M_E_--'1+-
SEPTIC TANK
1000 GAL MIN.
INDIVIDUAL
SEWAGE DISPOSAL
SYSTEM
/
~
LYELLS
11863 CNTY RD 320
RIFLE
COLORADO
A ':..or-
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" , " " " " " "' >m '" 103 10+
"" IQ6 H>7 106 '" '" "' H~ II '" "' 1H> 11?
'" 119 120 121 122 123 12.4 125 12 1~7 \2& 129 1)0
131 132 )JJ IJ-4 135 \JS IJ7 \~ I HO 141 H2 HJ
~~~ \45 146 147 148 149 ISO 151 15 ISJ 15+ 195 \:;I;
157 \:;& 159 160 \lit 102 163 104 I 156 15? HiS 1$9
!70 1?1 172 1n 17'1-115 11& 177 I 179 IW 1&1 132
\ A--
SUGGESTED CONFIGURATION
OF QUICK 4 UNITS
1. DEVIATIONS FROM NUMBER OF UNIT ROWS, AND
UNIT ROW LENGTH ARE AlLOV'JEO. MAINTAIN THE
TOTAL NUMBER OF UNITS. CLEARANCES, AND
DEPTHS SHOWN ON THIS PLAN.
CIVCO Engineering Inc.
P. D. Bt:J>: J 756,
Verno/, Olah 04078
'l'elephoDIJ: (135} 789-M48 FBJ:.· (801} 'l/J!J-4'186
ORIGINAL
•"'-"~ SHEET
RE\ASIONS 1 &.·-·~·-If----..., &!·-..
&!·-·
MAY-22-<'008 ( THU) I a: 29 GOLDEN VILLA HOMES (FAX)l9702455475
CIVCO Engineering, Inc.
Msy22,200S
Dennis E!rown
Dennis Brown excavation
1200 Co. Rd. 248
Rifie, CO 81650
Dear Penn is:
Civil Engineering Consultants
P.O, Box 1758
1256 West 400 Sooth
Verml. Utah 64078
S~:~bjoct Englnoet's Cortification of IndiVidual Sewage Dlsposal System
I have Inspected and hereby certify the Individual sewaga disposal system that you have Installed fer
Mr. /.yells In Rlne. Colorado. I have found the system's construction to be In accordance with the
design calculations and constru<::tlon drawings that I prepared. All aspects of my design have been
followed Including minimum septic tank sl~e, pipe run lenglhsand minimum number of lnfiltrotlon units,
If you have any questions or retjulre additional Information regarding this s<!Wage disposal system,
please let me know.
Sincerely,
Vance V. King. PS
Engineer
CIVCO Englneerlng,lnc.
Wl</wk
Enci~sure
Cc: l"roject File
Phon" (435)789-5448 • Fcx (435)789-4485
Email: vaneeking@eivcoengineering. com , .
p 0021002