HomeMy WebLinkAbout01931 _ T •
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
,+ + 109 8th Street Suite 303
Glenwood Springs, Colorado 81801
Phone (303) 945 -8212
a n Q .f This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT `., 1931 a building or use permit.
Owner Dan & Wary Ann Keatins
System Location 0095 Sage: Swale Road Carbondale
Licensed Installer WO Horse Woodworks, Inc.
Conditional Construction approval is hereby granted for a /j! • t _ i gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in • - • _ minutes requires a minimum of sq. ft. of absorption area per bedroom.
Js"
Therefore the no. of bedrooms 3 x sq. ft minimum requirement = a total ofd �sq. ft. of absorption area.
May we suggest:
Date -- - -` . Inspector , '. r
FINAL APPROVAL OF SYSTEM: p 1 C�'p-, g5.. f "r t>1� Q N p G CC ( p ( Vt I ei C f0'Y ' •
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved /prior to cover•
ing any pa rt.
e / .- Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
Proper materials and assembly.
./0/50 i Trade name of septic tank or aerated treatment unit. Gfl�
J ' Adequate absorption (or dispersal) area. 32))CS CerdclC'Fa r •
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Otter
Date Inspector a =ra - 7 . - -
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. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall
automatically be a violation of 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.).
Applicant: Groan Copy Department: Pink Copy
,t rc.it ion
• 4 1III11VIUlIAL SIWAGE DiSPOSAI. sYS11,1 APPLICATION Approval by
County Official:
01111Elk a/ kie/44/ - V
--
ADDRESS o tU� 1 j 4401i/4✓ _ DJ g I'IIONr4i4 2-5067 4 Sd ✓
GOIDC1OR_ /did ' '¢fi e s . -- Y ti
AnuRESS_AeS At ...d ZP -. X99`_ ._ _ _ 1'I ION f�3v :11 r
I'I:RM11 Itt:QUEST FOR: ( ✓) New installation ( ) Alteration ( ) Itepair
At Loch separate sheets or report showing enLire area w 1 lh respect. to surrounding areas,
topography of area, habitable building, location of potable water wells, soil pei col a1ion
test holes, soil profiles in Les holes. (See page 1.)
LOCA11011 OE PROPOSED FAC1I.1TY: County _.oa j cla .... _... ___— .--_-_. --
Ilear what City of town 4 o°de Lo t. Size __ e?ac1 ___
,Legal Uescripi ion .._..__ c(o/ 4.___ Sea, . _ laea
WASTES TYPE: ( ✓) Dwell ing ( ) Transient Use
( ) Couunercial or Ins 1it.o1lona1 ( ) tlon-dome:. tic Wastes
( ) Other - Describe ------ --.___.._._...._.._-- ---- -- - - -. -- - - - -_.
RU LLD IIiG OR SERVICE TYPE:
Ilnurber of bedrooms 3 efleor S Ilumber of persons `___ ________
i l ( V) Garbage grinder ( L) Automatic washer ( t) 11ishwasher
SOURCE AHD TYPE OF WATER SUPPLY: (. ) we 11 ( ) spring ( ) r.I:ream or creek
t;iv• depLb of all (•(ells within 180 feet of system : _ t --_ --
'u.,l ppi ied by con waLer, gi ve name or suppl .D ' 2.u.k._ 5u6,___.____
GROUND CONDITIONS:
Depth to bedrock: thakjap t"� — -- — — — — -- — . __.— -
i Depth to first Ground Water table :.(1 _/'LiSn-c-.,4 - —. -
--- _- --- - --
Percent ground slope:'f S 7o ____
—_—_._..---____
I)ISTANCE TO NEAREST COMMUNITY SEWER SYS11M: . k7 1 . Was an an effort made to connect to comnuni ly system?___ /1/ v — _ ___.--_.-__
Pin 01 IDOI SWAG! DISPOSAI. SYSIIII I'ItOPOSLIl
( V) Septic Tank ( ) Aeration Plant ( ) Vault
( ) Vault Privy ( ) Composting toilet ( ) Recyclirr!t, potable use
( ) Pit Privy ( ) Incineration loilet ( ) Recycling, other use
( ) Chemical Toilet ( ) 01 her •- Desc vi be: __.— ..___...— — _._---- ___ -- --
FiNAL DISPOSAL BY:
(t/) Absorption Trench, Bed or Pii. ( ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Palter
( ) Above Ground Dispersal ( ) Wastewater I'ond
( ) Other - Describe: —_. _.-- ___ .-- -_ -- --
WI .I FLUENT 11E DISCHARGED DIRECTLY INTO WATERS 01 1 111: STATE? /Lib _^.... _-____ __
•
50111'1: tC0LAT1011 1EST REStii.TS: (To be comp lefed by Registered Pro fe'.';iona1 Engineer.)
I•linuees _ per inch in hole no. 1 Minutes per inch in bole Ho. 3
Minutes ' per inch in hole No. 2 Minutes per inch in hole Mo.
•
Han address and telephone of RPE who made soil absorption tests:
Maine, 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 hea
department to he made and furnished by the applicaul. or by the local (real MI department for
purposes of the evaluation of the aaplicaI.ion; and the issuance of the permit is subject to
such terms and conditions as deemed necessary to insure compliance with rul es and regulations
adopted under Article 10, Ti 11 e 25, C.R.S. 1973, as amended. The undersigned hereby certifies
Cha all statements made, information and reports submitted herewith and required to be
submitted by the applicant are or will he represented to be true and correct to the best
of my knowl edge and belief and are designed to be relied on by the 1nca1.departnent of heal th
in evaluating the same for purposes of issuing the permit applied for herein. 1 further under-
stand 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 per-
jury as provided by law.
-Da te �� �2i -3 /9 S/ Signed a '9 nn
•
I'Le. DRAW AND ACCURATE MAP TO YOUR PI201'IIIRTY
•
•