HomeMy WebLinkAbout02070 t
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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit
.„ 2 0 7 0
109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81801
Phone (303) 945-8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. f
PROPERTY 1
/ Bonnie D. Rornysk ' 3210 CR 114, Glenwood Springs 928 -0657 1
Owner's Name Present Address /, Phone
1757 County Road 241, New Castle
• System Location f
Legal Description of Aise§so'6 Parcel No. , ' . -
SYSTEM DESIGN
. , Nor. T7I r /an..,' t. 4 f 21 RL,AM I
y;,., . , 1 ° 5 ' 0 0 Septic Tank Capacity (gallon) Other C t.c' ^.,G: - ,' to 'r ( t¢::.r+ , i s W« -) , &''' ,
6141, K5, ..:)7i77 A tvAY << ", Bit I
/!) Percolatidn Rate (minutes/inch) Number of Bedrooms (or other) r., i ',.< ta-.., s
Required Absorption Area - See Attached ( =' r N ' / ` � t 1' f- h c f5 f7 C' rY 'i ^) F u. t moo R. 4YO 4iO /l� /)NCAR et Tp,.t Nr- 1 ' f 47v 7
.mow C
Special Setback Requirements: piz b 759 1 7 -
D r te .*// /Y.5 Inspector /' .r / G cc �u' ` � � ,
FINAL S'S EM INSPECTION AND APPROVAL (as installed)
Call for Ins ction (24 hours notice) Before Covering Installation • I
a 'ystem Installer � u kgGG`r
f,
Septic Tank Capacity 2"../Q/)/ GAU NS
Septic Tank Manufacturer or Trade Name IC,& ' b newt(
Septic Tank Access within 8" of surface ✓
Absorption Area } ( 1 9 r k 70
' 12 1,0 r--t
r
Absorption Area Type and /or Manufacturer or Trade Name - - r ) r ` I
Adequate compliance with County and State regulations/requirements 40
Other - a . / . . _ _ . ir 1 " " 1 ' 1
Date • • Inspector` , //>' i nO lirr
To3
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 4 �� .0
'CONDITIONS: I/ r
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sti age D)$F�64a1 Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1984. \ i' -
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 (8500.00 fine — 8
months In jail or both).
I
Applicant: Green Copy Department: Pink Copy
f 111 INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Application Approval by
County O�fieial
OWNER goA1N /E D •2,v�A. �K y
QQ � t ¢¢,/y/vii_._'.."
ADDRESS /757 Cg 24 / New (4s7f Go, PHONE 9fr 7 `^ � ( r�� o
CONTRACTOR F f/ 100°4 ���'''III 0 ,
ADDRESS PHONE 14
PERMIT REQUEST FOR: ( ) New Installation ( ) Alteration (X) Repair
Or
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 &7ftf - 6 D
Near what City of Town /(/Ezi/ C4 5 E Lot Size 4' . 2 2 .4 C
Legal Description S'Lt7 /oQ / 3 'To2v ,V S4 /1 5 /24 4 E 2/
WASTES TYPE: ( 7C) Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE: /e !/ D t/J T //g L
Number of bedrooms 6 Number of persons 4
( ) Garbage grinder (>G) Automatic washer ( ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ") well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system: 70
If supplied by community water, give name or supplier: nil el
GROUND CONDITIONS:
Depth to bedrock: Depth to first Ground Water Table:
%Percent ground slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: I o u e
Was an effort made to connect to community system?_ NIA
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:
( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration
(;X) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe: __.�
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?
Page 2
4 .
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:
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.
Date
4(22;e1-9 a7 / 993 Signed
PLEASE DRAW AND ACCURATE MAP TO YOUR PROPERTY
Page 3
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j M AY 2ol993 21
� rte.- (- AFcFtap col) wry
May 20, 1993
Mr. Michael Watts
Garfield County Building Department
109 8th Street, 3rd Floor
Glenwood Springs, CO 81601
RE: Homyak I.S.D.S., 1757 County Road 241
HCE Job No. 93004.06
Dear Michael:
On May 18, 1993, High Country Engineering, Inc. personnel visited the I.S.D.S. site for the
residence located at 1757 County Road 241 (East Elk Creek), and observed the site for the
proposed I.S.D.S. and the associated profile hole and percolation test holes. The soil profile
was mainly approximately four to five feet of very sandy soil underlain by gravels. There
was ground water present in the gravels just slightly below the top of the gravel layer.
The proposed absorption field location (just west of the house) could meet the required
setbacks from the house, the property lines, and the creek. Based on scaling from the Flood
Insurance Rate Map, the required 50 foot setback from the creek will contain the 100 year
floodplain, therefore, the proposed field location is outside of the 100 year floodplain, as
shown on the current Flood Insurance Rate Map (copy enclosed).
We have enclosed calculations for sizing the bed, as well as a typical cross - section for the
proposed bed.
If you have any questions or need additional information, please call.
Sincerely,
HIGH COUNTRY ENGINEERING, INC.
�o���uummuak
lU.l� 1 ls::* °eau *:44,,
thy P. Beck, P.E. : .o o F
Ti •
Prin ipal Engineer ' 20630
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923 Cooper Avenue • Glenwood Springs, CO 81601
Telephone: 303. 945.8676 • FAX: 303. 945.2555
'ra` Job Titl S Job No. j ,1 q41°
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923 Cooper Avenue • Glenwood Springs, CO 81601
Telephone: 303 - 945 -8676 • 303 - 920 -3669 • FAX: 303 - 945 -2555
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I EL NATION REFERENC
REFERENCE ELEVATION DESCRII
MARK (FT. NGVD)
RM11 5549.06 U.S. Army Corps of Eng
spike in a power pole west
Castle; 75 feet east of the C
RM12 5544188 U.S. Army Corps of Eng
` �7 spike in a power pole 35 1
i feet east from the dirt ro
west- southwest of New Ca:
• ZONE A RM13 5589.97 U.S. Army Corps of Eng
spike in a power pole 15
Road 335 and 45 feet sot
Alkali Creek about 1 mile
1
. To determine if flood insurance is available in this community,
• contact your Insurance agent, or call the National Flood Insurance
.28
P at (800) 638.6620. I I
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A PPROXIMATE SCALE IN FEET ■
t000 0 1000
IIIIIIIIIIIIII NATIONAL FLOOD INSURANCE PROGRAM I
FIRM
FLOOD INSURANCE RATE MAP
GARFIELD COUNTY,
COLORADO
(UNINCORPORATED AREAS)
33 \ __
PANEL 1015 OF 1900
(SEE MAP INDEX FOR PANELS NOT PRINTED)
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T. 5 S. `I COMMUNITY•PANEL NUMBER
080205 1015 B
T.6 S.
j MAP REVISED:
J ANUARY 3, 1986
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111111 Federal Emergency Management Agency
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15 8 INVOICE
D -PLUS ENTERPRISES Phone: 303/927 -3431
Dreager Excavation FAX 303/927 -3996
P.O. Box 1000
Basalt, CO 81621
Date: 6/4/93
TO: BONNIE HORNYAK Job: SEPTIC SYSTEM
Loc:
BID
EQUIP DESCRIPTION N UNIT RATE TOTAL BALANCE
0.00 0.00
TRUCK D6 TS HAUL 2.00 HRS 50.00 100.00 100.00
3/4 SCREENED ROCK 13.80 TON 5.65 77.97 177.97
TRUCK D4 LB HAUL 7.50 HRS 50.00 375.00 552.97
3/4 SCREENED ROCK 45.22 TON 5.65 255.49 808.46
LABOR DB INSTALL SEPTIC 7.50 HRS 22.00 165.00 973.46
LABOR RH BUILD LEACH FIELD 10.00 HRS 22.00 220.00 1,193.46
LASER 1.00 DAY 85.00 85.00 1,278.46
SKIDLOAD GM MOVE IN 1.00 HR 60.00 60.00 1,338.46
HOE 4 GM LOC TANK,EXC FOR NEW 0.00 1,338.46
TANK & BED, BACKFILL 7.50 HRS 90.00 675.00 2,013.46
LABOR GM LAY PIPE 2.00 HRS 22.00 44.00 2,057.46
SKID LOAD RS BACKFILL 9.50 HRS 60.00 570.00 2,627.46
MATERIAL 1,526.67 4,154.13
4" PERF PIPE 180.00 FT.
4" SOLID PIPE 180.00 FT.
4000 GAL TANK 2.00 EA
RISERS
FILTER CLOTH 1040 SQ.FT
MISC. CONNECTORS
NOTE: Sale of material takes place and title of goods transfer
at retail place of business