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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit { 2 3 7 2 i it
109 8th Street Suite 303 Assessor's Parcel No. i i
Glenwood Springs, Colorado 81601 ( t
Phone (303) 945-8212
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This does not constitute t i
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. 44.
PROPERTY 4Y
Owner's Name Andy O'Brochta Present Address 1826 Grand Avenue, Glenwoggone_ 945 -7451 x a
0106 Deer Valley Drive S rin ride Lot 14, Glenwood 8 rin a r
System Location Y • P 8 8• • V 8 a
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
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ii .)
ak
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes /inch) Number of Bedrooms (or other) i I
Required Absorption Area - See Attached
Special Setback Requirements: / 4 Ii i t
Date Inspector - --: r 'r - -- -- / 41 �
FINAL SYSTEM INSPECTION AND APPROVAL (as installed) It
Call for Inspection (24 hours notice) Before Covering Installation 1
System Installer k� j.: +- J 7 � : 1 ) P C 4-il Y 4 t ,rr n / ti
Septic Tank Capacity ` /: A. I-- ('' s
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Septic Tank Manufacturer or Trade Name 4.a c-5.4 r4 —. .
ir 4
Septic Tank Access within 8" of surface �'.. -..".. r (
• ".:7 w - - tom ,. L
Absorption Area 2 r `� / , .. , f.., 7 . � 1 -,.. / / ,.L r l ,t: .,, / 6
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Absorption Area Type and /or Manufacturer or Trade Name SA' f r L . �� _.1
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Adequate compliance with County and State regulations /requirements
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Other 4
C —�--
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Date /9 9' 7 </ Inspector ( c�
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE rif
*CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter l
25, Article 10 C.R.S. 1973, Revised 1984. n
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- t 1
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation ora f i
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 t s
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).
0
Applicant: Green Copy Department: Pink Copy
JNDIVIDTJAT, SEWACGF DISPOSAL, SYSTEM APPLICATION
OWNER "fate '- 1 ,9enr A
ADDRESS •//7a. I&. f%4 ..nZ 't1, PHONE
CONTRACTOR 'D. M• £/ ./neA.d /ro vsr Co .
ADDRESS 310 ( 9 f k. S1 l'?o • I3ofZ4'1 PHONE 915 -75 z_
PERMIT REQUEST FOR (v)'ILEW 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).
J.00ATION OF PROPOSED FACILITY: COUNTY Ctr
Near what City or Town G/ea/ca.. p S OGS . Lot tit
Legal Description
WASTES TYPE: (Dwelling () Transient Use
( ) Commercial or Industrial ( ) Non - domestic Wastes
( ) Other - Describe
BUILDING OR SERVICE TYPE:
Nu9aber of bedrooms: ' Number of persons • ti
(4 Garbage Grinder ( utomatic Washer (
SOTJRCE AND TYPE OF WATER SIMPLY. () WELL ( ) SPRING ( ) STREAM OR CREEK
Give depth of all wells within 180 feet of system: w ASR s y s
If supplied by communtiy water, give name of supplier: Pee I A) t� .A) R
(TROT JND CONDITIONS:
Depth to bedrock:
Depth to first Ground Water Table:
Percent Ground Slope:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 3 — M 1 e c5 <
Was an effort made to connect to community system? A/ D
TYPE OF DIVIDUAL 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:
(t 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?
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pRRCOT ,ATION TEST REST 1 TS: (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 appliction 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 inusre compliance with
rules and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The undersigned hereby
certifies that all statements make, 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 bre relied on by the local department of health in evluating the same fro purposes of issuing
the permit applied for herein. I further understand 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'u a provided by law.
Signed Date
PT .EASE DRAW AN A .Ca JRATE MAP TO YOIJR PROPERTY
PI .0T PLAN ANT) DESIGN FEATI IRFS
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.
cut tb'i
Iigr` \VORTII- P1tVLAK GEOTFCHNIC. \L, [NC. 1020 Road 154
Sprint.. CD 81601
Pax t0 )''15 N4$i
November 14, 1994 ;'Mon ;: l )45. 988
D.N1. Newnan Constriction
Attn: Duane Neuman
P.O. Box 2317
Glenwood Springs Colorado 81602 Job No, 194 443
Subject: Percolation Testing Results, Proposed Obrochta Residence, Lot 14,
Springridge, Garfield County, Colorado.
Dear Duane:
As requested, Hepworthi-Pawiak Geoteehnical, Inc. conducted a percolation test at the
subject site for design of an infiltration septic disposal system for the proposed residence.
v,Ve previously conducted a subsoil study for the residence and pr scntcd our findings in a
report dated October 10, 1994, Job No. 194 443.
. \t the time of our site visit on November 3, 1994, a profile pit and 3 percolation holes had
been dug with a hackhoe at the approximate location shown on Fig. 1. The profile pit was
4 feet deep and below about 1 foot of topsoil exposed silt. clay and sand mixed soil with
sandstone pieces to cobble size. Then were scattered sandy and rocky layers. The results
of standard property tests conducted on samples taken from the profile pit are shown on
Fig. 1 sad summarized in Table L No free water was observed in the pits.
*he percolation holes were prepared and soaked on November 3 and In Table percolation
11. Bas
r;;. tin was conducted on November 4. The test results are presented
.v: the subsurface profile encountered and the percolation test results, the tested alto is
,'. :itabie for an infiltration septic disposal system. The rapid rate measured at P-2 is
i 'vobably duo to a localized rocky layer and should be ignored in sizing the system.
(f you have any questions or if we can be of further assistance. please !et us know.
Sincerely.
HGPWORTH•PAWL: \K GEOTECHNICAL, INC.
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Steven L. Pawlak, P.'+ .
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SLP /ro r O C�4� f
Approximate Scale
= 100'
Deer Valley Drive
Lot 14
1
1
Lot 13
Percolation Proposed
Pits •�
P -3 Residence
Lot 15 `
P•2 L'
Profile -
11 P't
Pit /a 460- Pit 2
Lot — G " _
. Boundaries / j %
Irrigation— ' - - - - Lfluxsi:
Ditch
D Previous Exploratory Pits
October 10, 1994
I NPPwf1RTN- PAWLAK I _ 1 v,ne.:nn of Parenlation Pits Fig. 1
1 .urn- --
r $IP,VO ANALY 919
IIYDROM0T6R ANALYSIS U
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, ]RAVEL 40 Y SAND 44 % 51L7 -NO CLaY - 16 •".
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$AMPLE ;F .: .. - ` - }' sand il'.:, grave:, .• .
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LIQUID UMIT PTIG
I S A FROM
194 443 1 HEPWORTH- PAWI.Ai GRACAT:CN TEST' RESULTS I Fig. 2
G Inc.
HEPWORTH - PAWLAK GEOTECHNICAL, INC.
TABLE II
PERCOLATION TEST RESULTS JOB NO. 194 443
HOLE NO. HOLE DEPTH LENGTH OF WATER DEPTH WATER OEPTH DROP IN AVERAGE
(INCHES)' INTERVAL AT START OF AT END OF WATER PERCOLATION
(MINI INTERVAL INTERVAL LEVEL RATE
(INCHES) (INCHES) (INCHES) IMIN /INCHI
p -1 52
15 8 6 2
refill 8 3/4 7 1/4 1 1/2
refill 7 3/4 6 1/4 1 1/2
refill 81/2 71/2 1
7 1/2 6 1/4 1 1(4
refill
8 1/2 7 1/2 1
71/2 61/4 11/4 13
P -2.
69 1!2 15 9 3 1/4 5 3/4 --
- -'
refill 9 4 5
refill 9 3/4 6 1/ 4 1/2
refill 91/4 5 4 1/4
refill
9 314 0 1/4 3 112
refill 10 6 4
refill 9 3/4 6 1/2 3 1/4
refill 9 314 ...
P 3 6 3/4 3 1/2 4 1/7
__
- -- --- 52 15 8 1/2 5 1/2 3
refill
8 3/4 8 114 2 1/2
refill 8 3/4 8 3/4 2
refill 9 61/2 21
refill 83/4 71/2 1 1/4
7 1/2 6 1/2 2
8 1/2 7 1 1(2
refill — 9
7 6 1/4 1 3/4
Note; the percolation n tests of backhoe
wore conduotedonNovembo soaked on November 3 and
November 4, 994
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