HomeMy WebLinkAbout02022 e t i / 4;
1 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N: 2022 d
109 8th Street Suite 303 Assessor's Parcel No. i
Glenwood Springs, Colorado 81801 2393- 283 - 00-013
Phone (303) 945-8212
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This does not constitute ,)
INDIVIDUAL SEWAGE DISPOSAL PERMIT " 4%1). S cap 2 2 a building or use permit.
PROPERTY - 1
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Owner's Name Larry Woolley Present Address P•0• Box 487, Basalt Phone 927 -.3124 t
System Location County Road 106 Carbondale 4
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Legal Description of Assessor's Parcel No. • + i
SYSTEM DESIGN ,.
i j A 0 Septic Tank Capacity (gallon) Other- -
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M n,1 3 . • ,
Z droo ns other)
Required Absorption Area - See Attached
Special Setback Requirements: '
Date 10_ 42 7 Inspector 6:24.u-k-41,41._
FINAL SYSTEM INSPECTION AND APPROVAL {as i *t94 s
Call for Inspection (24 hours notice) Before Covering Installation "
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System Installer
_A� Lr�6mt,g,�
Septic Tank Capacity MA So
Septic Tank Manufacturer or Trade Name J) _7 tt ]G a OK,
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Septic Tank Access within 8" of surface ' . t '(
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Absorption Area • - _ _ . - =
Absorption Area Type and /or Manufacturer or Trade Name < L7a.ssr .R.. S r_ -+
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Adequate compliance with County and State regulations/requirements 9f3
Other
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Date 4 NV 94- Inspector '.. _ _.. % • i
RETAIN WITH RECEIPT RECORDS A CdNS / TION SITE `.
*CONDITIONS: }
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter I
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 off ice 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 — 8
months in jail or both).
Applicant: Green Copy Department: Pink Copy
Application
. INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
'OWNER ' 4?ieY 144 /f`Y�,- Brrry Lov Ale SEA./ County Official: op
ADDRESS /0 /go 587 2=2.5-4/1 5,4//� %> PHONE
CONTRACTOR 54
ADDRESS PHONE
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: County ��t-Ko /c/
Near what City of Town 7 Lot Size 4/ An„o.ie.--
Legal Description /// . / 49.-/, o ,, r //, ,Bo na/ /, .� .2 Tny.i r, {/t
7.foii,Q' ,c , �rA /va€ ( / /yleren0:4,,v 971:e c7 ,/ iii7/�7��e�y
WASTES TYPE: (1-'1-Dwelling ( ) Transient - 0 - se ' k ' cider
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: h e---c adr c
Number of bedrooms 3 Number of persons Z
( ) Garbage grinder ( ✓ - Automatic washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (,/j well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: 77n-zed
If supplied by community water, give name or supplier:
GROUND CONDITIONS: '2 / e p fj >ys/ k e � , - , /jP se /ate S
Depth to bedrock: CAP/ kr n
Depth to first Ground Water Table: LJnGCnow/rt
Percent ground slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 1 n.,121/4_
Was an effort made to connect to community system? Ait, '
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( ✓f Septic Tank ( ) Aeration Plant ( ) Vault
( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use
( ) Chemical Toilet ( ) Other - Describe:
FINAL DISPL BY:
( Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe:
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? `7p.-j
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P .
'OIL:PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer.)
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 Mo.
Nance, address and telephone of RPE who made soil absorption tests:
Name, 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 health
department to be made and furnished by the applicant or by the local health department for
purposes 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
adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby certifies
that all statements 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 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. Q
Date 7 ` /•� / q L - 15 49 15 a-i7
PLEASE DRAY! AND ACCURATE MAP TO YOUR PROPERTY
Page 3
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PLOT PLAN AND DESIGN FEATURES:
Include by measured distance location of wells, springs, potable water supply
lines, cisterns, buildings, property lines, subsoil drains, lake, water course,
stream, dry gulch and show location of proposed system by direction and distance
from dwelling or other fixed reference object, and additional submissions in
support of this application such as data, plans, specifications, statements and
commitments.
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Page 4
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Dispersal - ,/, A (0.5) A(0.6) MO 6)
PERC BED Bedroom Area Y Trench Pieces a Pieces MS
• RA E ROOM ` E Cs `t fl2 FIy FTs Pieces ___
• 19 1 4131 160 240 13 2E3(3 15 2E313 17
2 275 549 1(33 275 15 3301 1(3 3311 20
3 024 275 412 22 494 26 494 30
4 1098 366 549 29 659 35 659 39 --
1 493 164 247 13 296 16 296 113
2 282 563 1813 202 15 338 1E1 330 20 ,
a 423 23 =
4 176 563 30 676 36 11
127 3 76 i llt
21 1 505 168 253 13 303 16 303 18
2 289 577 192 289 15 346 18 346 21
? 866 2139 433 23 520 28 520 31
4 1155 385 577 31 693 37 693 41
22 1 517 172 259 14 . 310 17 310 1.9
2 295 591 197 295 16 355 19 355 21
3 (386 295 443 24 532 28 532 32
4 1182 394 591 \- ` yF 32 99 � :38 709 42 --
23 1 529 176 264 � k 14 ` 7 17 317 19
2 :302 604 201 302 16 363 19 363 22
3 906 302 453 24 544 29 544 33
4 1209 403 43 725 39 725 43 —_
24 1 540 160 2.70 14 324 17 324 19
2 309 617 206 309 16 370 20 370 22
: 926 309 463 25 `556 30 556 33
4 1235 412 617 33 741 40 743 44 - --
25 1 551 164 276 15 331 18 331. 20
2 315 630 210 315 17 378 20 378 23
3 945 315 473 25 567 30 567 34
4 1260 420 630 34 756 40 .
7m4 i, 45
26 1 562 187 261 15 337 10 t 7 20
2 322 642 214 321 17 3E15 21 3 m 23
3 964 321 462 26 57E3 31 5 r 7i: 35
4 1285 428 64 34 771 41 771 46
27 1 573 191 286 15 :344 18 344 21
2 327 655 218 327 17 393 21 393 24
3 9E32 327 491 26 5139 31 509 35
4 1309 436 655 35 706 42 786 47 „ _
28 1 583 194 292 16 350 19 350 21
2 333 667 2 333 18 4001 21 400 24
3 1000 333 500 27 600 32 600 36
4 1334 445 667 36 800 43 800 413 - --
29 1 594 190 297 16 356 19 356 21
2 339 679 226 339 18 4017 22 407 24
3 1010 339 509 • 27 611 33 611 37
4 1357 452 679 36 814 43 014 49
30 1 604 201 302 16 362 19 362 ••
2 345 690 230 345 1E3 414 22 414 25
3 1035 345 518 28 621 3:3 621 37
4 1360 460 690 37 (328 44 028 50
31 1 614 205 307 16 368 20 368 22
2 350 702 234 351 19 421 22 421 25
3 1052 351 526 28 631 34 631 38
4 1403 468 702 37 642 45 1342 50 _. - --
32 1 624 200 312 17 374 20 374 22
2 356 713 238 356 19 426 23 426 26
3 1069 356 535 29 642 34 642 38
4 1426 475 713 36 855 46 855 51