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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945·8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit N'.:'. .. J 6 5 2
Assessor's Parcel No.
This does not constitute
a building or use permit.
Owner's Name PcJMcJ .. e) VV\ ic;,~e I Present Address O'J &'OCR.1Jl ".,S '1/t..oJ Phone 9 d$-'85 3 '7
System Location ___ ~0~'7~~0~C~t\~/ _J..~1~~<;'_,~S_Co~_g_{(,_of _______ _
)lgc_;-~'? { ---oo-ofl
Legal Description of Assessor's Parcel No.-------------'-------------------------
SYSTEM DESIGN
______ Septic Tank Capacity (gallon) ______ •Other
______ Percolation Rate (minutes/inch) Number of Bedrooms (or other) ____ _
Required Absorption Area -See Attached
Special Setback Require ents:
Date _______ ~,__ ____ tnspector ___________________________ _
FINAL SYSTEM INSPECTION AN
Call for Inspection (24 hours notic Before Covering Installation
Septic Tank ~anufacturer or Trad
Septic Tank A~cess within 8" of su
\
Absorption Are·~\\-------+----\--"---l--------------_....-+1'b""''--t--l.--"---\.--
Absorption Area T
Adequate complianc
•CONDITIONS: i),A) (!"-lJ
1 RETAIN WITH RECE\!iT REC£RR8 AT 6~ ~·
1. All 1nstallat1on must comply with all requ1remen Colorado State Board of Health lnd1v1dual Sewage Disposal Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1964.
2. This permit 1s 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 ($500.00 flne-6
months in jail or both).
Whtte -APPLICANT Yellow. DEPARTMENT
• •
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION & CRITERIA
Stag t APP' 'G'TION
A. Obtain a standard "Individual Sewage Disposal Systam" application from:
Building and Planning Department
109 8th Street Sui1e 303
Glenwood Springs 00 81601
970-945-8212 or 213$-7972
3f24/02 S:3S Pll
B. Retum completed application, map to property, site plan and diagram of si1e to the Building and Planning Department (Pages 2 and 3) and building
plans. INDIVIOUALSEWAGEDISPOSALSYSTEMPERMITSWILLNOTBE ISSUEOMTHOUT ANAPPROVE!llUILDINGPERMIT.
C Make check or money order payable to "Garfield County Treasure(' (The cost for the permit fee and percolation test is $150.00 or ff a Registered
Profllssional Engineer does the percolation test. the cost is $50.00 pennlt fee). FEESARENOTREFUNll'\Bl..E.
D. Your Individual Sewage Disposal Permit will be issued along with your building permit provided no prohibitive problems are encountered.
S!!lp II: PERCO!..A!!ON!ESTS (see detailed instructions on page 6)
A. Prepare three (31 percolation holes 4 feet deep, 8 to 12 inches in diameter, and 20 feet apart in the area of the proposed leach field area
(Instructions for post hole or back hoe holes are on page 4 ).
B. Fill percolation holes with water img for the required eight (8) hour soaking period.
C. Request percolation test by Sanitarian. (To avoid construction delay, we suggest arrangements for percolation test be made at lees! 24 hours prior to
the end of the soaking period). Please have at least lill.l§l gallons of water for each hole available at the site for the percolation test.
ml lrtFORTANT 1111
Please be advised that 1f the San1tarian's initial field viSit to your property reveals any unusual difficult1es such as high water table, excessive
percolation rates, bedrock, etc , the services of a Colorado Registen>d Profess10nal Engineer and/or Board of Health approval will be requin>d.
Sllp II: F!NALNPECTIQN
A. When all components are in place, connected and ready to cover, request a final inspection by the Sanitarian.
B. DO NOT backfill any part of the system prior to the Inspection.
C The initial fee covers the percolation test and one inspection before cover up. Any additional percolation tests will be charged at $100.00 each and
additional inspections will be charged at $42.00 each.
0. Upon final approval, carefully cover the entire system.
/ti IGlkt(... Pol)"'fl!E: INDMDUALSEWAGEDISPOSALSYSTEMAPPUCATION
oWNER ADDR~ss D1 ~6 Cou.n ty P-oad 12. 7
PHONE '17=~ -BS37
CONTRACTORADDRESS~~~-~---~~~~~~~~-
PHONE.~~~~~~~----~-~~~~~~~~--
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 or Town _._G ....... le .... n .... IAhM.=.~~Swtt"-'"~~'-=f-f--'Jt--=co ______ _
Size of Lot 2, q a<Vf C, f /
Legal Description or Address OIBO 121 124\A Cil.el/WJli# ~I a I --;-ti
WASTES TYPE:
OQ Dwelling
I) Transient Use
( ) Non-Domestic Wastes
{ ) Commercial Or Industrial
{)Other: Describe: _____________________ _
BUILDING OR SERVICE TYPE:
Number of Bedrooms.~'f~--------------
Number of Persons_-"----------------
( ) Garbage Grinder ~Automatic Washer ( ) Dishwasher
bttp://www.prflelckounty.comlbuildina_.and_plannin&lforms_and_documcnla_html/ISDS.htm
i •
SOURCE AND TYPE Of WATER SUPPLY:
~WELL () SPRING () STREAM OR CREEK
1# supplied by Community Water, give name of supplier:. _______ _
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: l IM j fe.
Was an effort made to connect to the Community System? ( ) Yes C>4 No
A tl!a plan It 119ulred to be aubmlttad !bat lndlcatat the foHow!ng MINIMUM diltaDC91:
Leach Flald to Well: 100 feet
Septic Tank to Well:
Leach Field to Irrigation Ditches, Stream or Water Course
Septic Syat&m to Property Lines:
50 feet
50 feet
10 feet
YOURINPMDUALSEWAGE D!SPQSALSYSJEMPERMfTW!LL NOT BE !SSUEDW!IHOUTA SITE PLAN.
GROUNQ CONDITIONS:
Depth to first Ground Water: ___________________ _
Table Percent Ground Slope: __________________ _
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
fiQ Septic Tank () Aeration Plant () Vault
l) Vault Privy () Composting Toilet ()Recycling/ Potable Use
() Pit Privy () Incineration Toilet ()Recycling/Other Use
() Chemical Toilet ()Other-Describe: ____________ _
FINAL DISPOSAL 8Y:
()Absorption Trench, Bed Or Pit
.K Underground Dispersal
( ) Above Ground Dispersal
( ) Evapotranspiration
( ) Sand Filter
( ) Wastewater Pond
()Other-Describe: ____________________ _
WILL EFFLUENT BE DISCHARGED PIRECTLY INTO WATERS OF THE STATE? No
3/24/02 5:35 PM
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. 4
RPE WHO MAOE SOIL ABSORPTION TESTS:
Name: __________________________ _
Address: _________________________ _
Telephone: ________________________ _
RPE RESpoNSIBLE FOR OESIGN OE JHE SYSTEM·
Name: __________________________ _
Address: ________________________ _
Telephone: ________________________ _
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Applicant acknowledges that the completeness of the application is conditional upon !such further mandatory and addltional tests and
reports as may be required by the local heatth department to be made and furnished by the applicant or by the local heatth 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:~ !f'~ Date:_'-(-'-~-~_-_D_;).. __
PLEASEDRAWANACCURATEMAPTOYOURPROPERTYll
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 CRIT!CAL. The rate of absorption is called the peccolation 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.
PERCOl.ATIONTESTMUSTBEDONEATTHEGROUNDDEPTHWHEREABSORPTIONWILL TAKE PLACE.STANDARDSEEPAGEBEDS
(LEACH FIELDS)AREINSTALLEDTHREE FEET DEEP,SOTHE PERCOLATION HOLES ARE DUG FOUR FEET DEEP, AT LEAST 20 FEET
APART,INATRIANGLESHAPE. THEPERCOLAT10NTESTISDONEINTHEBOTTOMONE(1)FOOTOFTHEHOLE:
A post hole digger, auger or back hoe 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. drywalls) 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 181 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 W!1EN THE TEST IS PERFORMED.
AN EIGHT 181 FOOT PROFILE HOLE IN THE LEACH FIELD AREA IS REQUIRED IN THE STATE OF COLORAPO TO DETERMINE THE
PROXIMIJY OE GROUND WATER AND BEDRQCK. (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).
PERCOLAT!OfHESTS FOR DRY WELLS !S£EPAGE PfIS)ARE peRFORMEDATTHE LEVEL OF THE BOTTOM OF THE PITIUSUALLY 10
mm.
See the following pages for
Applicant Information
Recommended Minimum Requirements for Individual Sewage Systems
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Dear Permit Holder,
Garfield County
BUILDING cl PLANNING DEPARTMENT
Code Compliuce Oftice
sbackett@garfield-county.com
Please refer to your building permit ownber 3 torr. issued l./-C/ ~oz....
A routine review of our open building permits indicates that we haft not receiwcl a request for an inspection
on this permit since Alon!<-..-.
Please be advised that building pamits expire, per Uniixm Building Code, section 106.4.4. "Ewry pa:mit
issued by the building official under the provisions of this code shall expire by limitatioo 8Dd become mill
and void if the building Cll' WOik ldtborized by auch pa:mit is not c:omDlfllDd within 180 days ftom the dlltO
of such permit, or if the building or work authorized by such pa:mit is suspended or abandoned at any time
aft« the work bas commenced fur a pcriocl of 180 days. Bdbre such work can be nc:onuneooDd,. a new
pamit shall first be ob1ained to do so, 8Dd the fee theaetbre sball be one balfthe amount required for a new .
pa:mit fir such wort, provided DO Cha 8 ba\'e hem lllllde or will be lllllde in the original plans and
specifications fur such work, and provided ibrthea'tbat such suspension or abandonment bu not cw eeded
one year. lnonferto renew ~ona pamit aftereapiaalioo. the pamiuee llhal1 pay a new full permit tee."
Please cootad this office at your very earliest convenience, in writing, to advise us about the status of your
pamitted WOik.
If you have uot respouded 1t'i*iu thirty days from the receipt of dlis uotice the permit will be dosed
_.a .,..._t .. t1d1• _.be pl•ed ill dlepoupatJ _,. .tdleConty Al1i•1tnoftkedlat
iadirafel dlat die wcd permitted-... 118t inlpected, ii aet appnwed ud dlat tile baildhlg or area llUIJ
llOt be leplly oecapied.
Thank you fur your cooperation.
108 8th Street, Suite 201, Glenwood Sprinfi!S, Colorado 81601
Garfield Cou,nty
BUILDING & PLANNING DEPARTMENT
G 1JS 5? lc'cO I
Dear Permit Holder,
Please refer to our previous letter, dated S? -2-'o t( , advising you that yqur
Building Permit, number 3'9 6 2... , was due to expire, per section 106.4.4
& 5 ofUnifonn Building Code, and that you bad been given an additional thirty days to
call for the required inspection or to request other action from the building department.
The above geunit has expired and been clOled. The work authorized by the permit has
not been inspected or approved. It is a violation ofColonido Revised Statutes 30-28-205 . .
& 210, Uniform Building Code section 109, touseorocc:upythe building or area unless
final inspections have been completed and a Certificate of Occupancy has been issued.
Records of this fiillure to comply are included with property records at the Garfield
County Cleric and RecOrders office. You are entitled to protest this action to the Garfield
County Board of Commissioners
Andy Schwaller
Building Official
108 8th Street, Suite 201, Glenwood Springs, Colorado 81601
SENDER ,_;o, !Pi FTE TUIS SECTION
.• _Comp!. ttem&·1, 2, and 3. Also i:omplel&
! · 1t8m 41Hlestrfcled Delivery Is desired.
• • Priilt yo6r name and address on the reverse ~ So that we cari return the card to you.
• Attach this card to the back of the mailplece,
· or on the front H space permits.
Agent
a-
c. Data ol Pellwry
a expresiMall
0 RetumRecelpllorM-
0 C.0.0.
4. Restricted Delivery? (Extra Fee) Cl Yes ';1
PSFonn3811,August2001 ~RetumRecelpt -~1
~---.
Tim Holliday
Subject:
Start Date:
Due Date:
Status:
Percent Complete:
Total Work:
Actual Work:
Owner:
Podmore , michael
Friday, March 19, 2004
Friday, September 03, 2004
Not Started
0%
0 hours
O hours
Tim Holliday
Will be putting the system in sometime in June
Septic system will be put in this spring
Sent experation letter on 8-2-04
Sent final letter on 9-3-04 closing out perm it per Andy.
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