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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit Nr 2121
109 8th Street Suite 303 A r'e Parcel No.
Glenwood Springs, Colorado 81801 ,
Phone (303) 945-8212 t
This does not constitute t
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. i
Y
PROPERTY Sophie B. ECheverris f
Echo Springs Development P.O. Box 1413, Glenwood 945 -2991 bd
Owner's Name Present Address Phone f
0 302 Pinion Drive, Los Amigos, Glenwood Springs
System Location
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
7) r !> Septic Tank Capacity (gallon) Other
7 4
/ �, J y/ Percolation Rate (minutes /inch) Number of Bedrooms (or other) 1
Required Absorption Area • See le, t
Special Setback Requirements:
Q —
/ ^/ J
Date 7...... 9 - 2[... Inspector �') k_� Al / ()�7 C ✓� 1
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
d�,.
� -y'
System Installer ' r {/�/� am " " - 1 2Ai '' u I •`� f
f'
Septic Tank Capacity / "
Septic Tank Manufacturer or Trade Name ,_,�,II ; ` «�
Septic Tank Access within 8" of surface !�'�/► y / �/
Absorption Area / �'7 O 1 - 9 '! /X 7. 3 ,
Absorption Area Type and /or Manufacturer or Trade Name (I ' (Tr-. ? 4-• „4..G1 c -4
Adequate compliance with County and State regulations/requirements "C" ------
Other RD AT CONSTRUCTION i
RETAIN WITH RECEIPT
Date J-- 0 7 .' Inspector �..
RECO S N SITE
*CONDITIONS: I,
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 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 — 6
months in )ail or both).
Applicant: Green Copy Department: Pink Copy
I,.. Application
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
County Official:
OWNER C c ' S Y` \.9�' �tvcIe/� 171C. .
ADDRESS f •of oy /9 G • AA f. PHONE q9r QQi
�
CONTRACTOR_ SA�"" f 5 2 > J r
ADDRESS _ PHONE
PERMIT REQUEST FOR: OC) 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: County C 7`E t`'t n i e_( 0. II
Near what City of Town G EIJUWdOID 11ltriv�-/ S�s Co . Lot Size J a- ens-
Legal Description / —
WASTES TYPE: ()( ) Dwelling ( ) Transient Use
( ) Conrnercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE:
Number of bedrooms 4 Number of persons
(X) Garbage grinder ('() Automatic washer (r) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: (N( ) well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: h O v- £.
If supplied by community water, give naive or supplier: LOS 1l hni 9'D; Ri AKC./1
GROUND CONDITIONS: /
Depth to bedrock: —
Depth to first Ground Water Table:
Percent ground slope: C A% )) e09.9 , tr L`.l_m_ L8 SS
DISTANCE TO NEAREST COMMUNITY SEWER SYS`[EM: 3 vY■ C. S
Was an effort made to connect to connnunity system? h 0 •
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
()() 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:
(/C) Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe: C p A E' A c,"C C) - S y 57 £ &n
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? YX 0
SOIL 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 No.
Name, address and telephone of RPE who made soil absorption tests: C'}\c)U N ob-- 4b -ven)
Name, address and telephone of RPE responsible for design of the system:
,.�, in"- ,An wa CD e v-- 4_1 c cot/to-4
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 pernittis 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 niy 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.
Date ! / q 1 q3 Signed �� .... • !. -A A, As
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
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S02 INFILTRATOR CONTACTOR f ' c _
Ft,tper Dispersal „/ A (0.5) A(0.6) A(0.6)
PERC BED Bedroom Area ` ff Trench Pieces Bed Pieces Trench or Bed
RATE ROOMS FT= / / FTs FT FT° Pieces
33 1 633 211 317 17 380 20 300 23
2 362 724 241 362 19 434 23 434 26
3 1086 362 543 29 651 35 651 39
4 1448 483 724 39 869 46 1369 52
34 1 459 153 230 12 276 15 276 17
2 367 735 245 367 20 441 24 441 26
3 1102 367 551 29 661 35 661 40
4 1469 490 735 39 682 47 882 53
35 1 652 217 326 17 391 21 391 23
2 373 745 248 373 20 447 24 447 27
3 1118 373 559 30 671 36 671 40
4 1491 497 745 40 894 48 894 54
36 1 662 221 331 18 397 21 397 24
2 378 756 252 378 20 454 24 454 27
3 1134 3711 567 30 680 36 6E10 41
4 1512 504 756 40 907 48 90754
37 1 671 i 224 335 18 402 21 402 24
2 384 766 ' 255 383 20 460 25 460 28
3 1150 • 38:3 575 31 690 37 690 41
4 1533 511 766 41 920 49 920 55
38 1 680 227 340 18 408 22 408 24
2 388 777 259 386 21 466 25 466 • 20
3 1165 388 582 31 699 37 699 42
4 1553 510 777 41 • 932 50 932 56
39 1 689 230 344 18 413 . 22 413 25
2 394 787 262 393 21 472 25 472. 28
3 1180 393 590 31 708 38 708 42
4 1574 525 787 42 944 50 944 57
40 1 697 232 349 19 418 22 418 25
2 399 797 266 398 21 478 26 478 29
3 1195 398 59932 717 38 717 43
4 1594 531 797 43 956 51 956 57
41 1 706 235 353 19 424 23 424 25
2 404 807 269 403 22 484 26 184 29
3 1210 403 605 32 726 39 726 43
4 1614 538 807 43 968 52 968 58
42 1 715 238 357 19 429 . 23 429 26
2 408 817 272 408 22 490 26 490 29
3 1225 408 612 33 735 39 735 44
4 1633 544 817 44 980 =re" 980 59
43 1 723 241 361 19 434 23 434 26
2 413 826 275 411 22 496 26 496 30
3 1239 413 620 33 744 40 744 45
4 1652 551 826 44 991 53 991 59
44 1 731 244 366 20 439 23 439 26
2 418 836 279 41E1 22 501 27 501 30
3 1254 418 627 33 752 40 752 45
4 1672 557 836 45 1003 53 1003 60
45 1 740 247 370 20 444 24 444 27
2 423 845 282 423 23.. 507 27 507 30
3 1268 423 634 34 761 41 761 46
4 1690 563 845 45 1014 54 1014 61
46 1 748 249 374 20 449 24 449 27
2 427 855 285 427 23 513 27 513 31
3 1282 427 641 34 769 41 769 46
4 1709 570 855 46 1025 55 1025 61
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