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HomeMy WebLinkAbout03711' \ ' 1 ~ • j ' , ' ' l ' .. GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT / ( 109 Bth Street Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945-8212 Permit N: 3711 Assessor's Parcel No. t INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY This does not constitute a building or use permit. :\ ! -r.;s.; ' i Owner'sNa"'JLUm;bcbvt PrasentAddressODDC Q~C d Phone9'·.\''$-\DDlo i System Location aa.D5 0 Q .. I ~1 G lD '5 94-:'l -l'ii'-1.:5 ~ Legal Description of Assessor's Parde1 No. ____ @ ...... ...,.d;-=-:=:'-)_...,_-_.;J~Y"--'-ci"'----_,,D"-'6=--..JIL""l.o_..,..,_ _____________ _ ' :, SYSTEM DESIGN l ,, I ' ' ' • I \ t I r ; ' : 1 ______ Septic Tank Capacity (gallon) ______ Other ______ Percolation R1;te (minutes/inch) Number of Bedrooms (or other) ----- Required Absorption Area~ See Attached ::~:-ia_l_S_e-tb_a_c_k_R_e_q_u_ir_•_m_•_n_ts_: ____ lnspector ______ ___.f:z_~~=-+-.-'-'='l~C.,_,__ __ ~_-_."_..~t:.->\~(-'-~-"e'...l--------- 1 FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation I • -· I ,.-,--~ system 1nstalle•---------------------~=.,...4-=-"'--'-f--'.n"-"1..".-~-=U'-·-/J"'--'-'(_·_,_""""-"':.:'-~ " . ',-. . \ Septic Tank CapacitY---------------------+-'-''='-"'-'=£:.-..V="------------- Sept1~.T"~,k Access wit\in a•· of surface _· -------------------------------- '--N-',. /-'~'4t Absorption Area---------------------------------------- Absorption Area Type and/or Manufaciurer<or Trade Name-------------------------- Adequate compliance with County and State regulations/requirements _____________________ _ • • .' ' • I ' '· • ' ~ Other ____________________ ~--------~~---------~~--, Date _____ lnspector /0(3/f 0 d-¥ ~ . t ' ' i ' r • .l ~ 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). Whtte -APPLICANT Yellow -DEPARTMENT ---- ' • .. " " INDIVIDUAL SEW AGE DISPOSAL SYSTEM APPLICATION • OWNER G<obe,.+ rJ) tf cfo ~ E". ADDRESS Ol+o ( .,.d,,.-(..-.-~+. G.ws ( 0 PHONE q 4s -(00 0 'CONTRACTOR Advc..J., ,e B~.\JPo K~v' . ..-.. g.,,_,9"" ADDRESS 0.:JSD Cc:>v ... {)~o{ llf; 6w5 (0 PHONE q4-s-7-1q3 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). LQCATION OF PROPOSED FACILITY: NearwhatCityofTown 6/e..,...,oc?J' ~P,..;"'§ s SizeofLot '3.S <1cre5 Legal Description or Address ~or; Cc:>v.,{J CtA 131-, (an';::I"""-Creel:.... WASTES TYPE: (V{i;'WELLING / ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( )OTHER-DESCRIBE. ______________ ~ BUILDING OR SERVICE TYPE:_~Q'-'-'-'f'l«-1,....J""".,~"!l-'.g___""----------------- Number of Bedrooms 4-be et' r-00-..s ( ~Garbage Grinder ( ~tomatic Washer SQURCE AND TYPE OF WATER SUPPLY: (~ Number of Persons __ 4-'----- (~shwasher ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: ___ ..... N~A_,__ ________ _ DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:_-k-'-'\'-=A.__ _______ _ Was an effort made to connect to the Community System? __ _:"-!.::~:.1.L----------- A site plan is required to be submitted th•t indicates the followinr 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 to Property Lines: (septic tank &leach field)10 feet YOUR INDIVIDUAL SEW AGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN. GROUND CONDITIONS: Depth ro first Ground Water Table _____________________ _ PercentGroundSlope ____ ~I......,.~_.___ __________________ _ 2 ~ -, • TYP~F INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: . ( v) SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POT ABLE USE • ( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET ( ) OTHER-DESCRIBE. ___________ _ FIN~POSAL BY: ( vJ ABSORPTION TRENCH, BED OR PIT ( ) UNDERGROUND DISPERSAL ( ) ABOVE GROUND DISPERSAL ( ) EV APOTRANSPIRATION ( ) SAND FILTER ( ) WASTEWATERPOND ( ) OTHER-DESCRIBE. ___________________ _ WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?_~N~o ___ _ PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes __ b __ ~per inch in hole NO. 3 Name. address and telephorie ofRPE responsible for design of the system: (}{ c b-> 14=2fdt) P. c. 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 couea 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 fillsification 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. Date. __ 0__,_(_P _,__(&_2-__ _ PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 \. . ~~ . .. Designate North Arrow Your Plot -Shape to Fit (No Scale) se~ ~~fo,J t;,.k_ Pte.~ Your Neighbor's Name & Address Your Neighbor's Name & Address ' . Locate well, all streams, irrigation ditchs, and any water courses. Draw in your house, septic tank & system, detached garages, and driveway. If a change of location is necessary, you must submit a corrected drawing, before a Certificate of Occupation will be issued. County Road (Note the Road Number and Name) enc c·\wpwm60\.wpdoea\paotloc l3AJ .. . ' ' O.~c~+- b/to/o~ ~ @) ® '-' c·, ->,).; S.1~ 3 rm.. '.) G..D\ -,{ '. s \ (p l't ; .... 1.D (, { f'/ ( IR.~ -:J..0 /. '"'~"--,1 ~ ~ ,,.,,,,, ..., 1 ..... 1. .. ,/ 1.J-< g_o '( Ii I 6 .... v..., I ' I J ......... fi.) < e.oo\ ,, 8.,C'o & // . ") 61 : :>< I '5' ... _ f _ !Pc -:> I( I I r / 111 :.., 'f'I, 7''- l:lub Oddo Oddo Engineering, Inc. 302 Eighth Street, Suite 325 P.O. Drawer 160 Glenwood Springs, CO 81602 RE: Oddo Re.idence -As-Built ISDS System, 2425 County Road 137, Garfield County Colorado SE Joh No. 221011.01 Dear Bob: Pursuant to your request, this letter provide!' documentation that the new TSDS •ystem recently installed i• in generul compliuncc with lhe permitted design. ne Oddo system has been completed. The system constructed on site was designed and built to serve the needs or an equivalent 4-bedroom home. Sopris Engineering bas performed vISits to inspect and document the a.• built condition.• of the con.•tructed system. We have coordinated our efforts with the owner and contractor that builr the system. The as built conditions and installotion of the new ISDS components is in compliance with the permitted design specifications for the system. The System was installed in accordance with Garfield County Regulations and the design requirements for a 4- bcdroom house ba.,cd on percolation test performed on May 10, 2002. A 1250 gallon dual oompartmcnt septic tanl:: wns intitalled with 4"' tee baffles and an effluent filter. A twc>-way clcanout wa.i;. installed between the house and the tank. The absorption field was cunslrucled with. 3 parallel chamber TOWll in trench <."Onfigurntion with 10 chambers per trench utilizing EQ-36 infiltrator gravcllcS<J chamber. Inspection ports were installed on each end chamber. The field is 80' by 12' approximately 36'' deep. The trenches were instnlled in suitable soil consistent across the field area. A di~tribution hox wM installed with n 4" riocr to 111<: >urfoo: and 3 individual distribution Ji...,. connected to end trend1. The construction wa.~ completed utilizing specified ma~e•ial• inotalled aet."Ording to the recotnmendatinns and do•ign .:akulalh>n• by Sopris J::nginc;<>ring, LLC. on All~wst 14, 2002. Th< minimum setback distt1J1~es have been maintained. Attached is schematic design sheet of the system. A 4" seweJ pipe stub oul was installed on the influent line to the distribution box for a future bathroom in a (lroposcd barn StrtJ<.'!UfC. If you have any question or need tlllY additional information, please call. Sincerely, SOPRIS ENGINEERING, I.LC j 502 Main Street • Suite A3 • Carbondale, CO 81623 • (970) 704-0311 •Fax (970) 704-0313 SOPRIS ENlllEERINI llC civil consultants TO .. d l.l.6Z-5176 Ol.6