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Home My WebLink About02671 4 sr! ` ♦ GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2671 109 8th Street Suite 303 Assessor's Parcel No. / . Glenwood Springs, Colorado 81601 - Phone (303) 945-8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Owner's Name Orval & Elsie Sa present Addres 0350 Ingersoll Lane, Sit t Phone_ 900 -876 -9946 System Location 0350 Ingersoll Lane, Silt — Legal Description of Assessor's Parcel No. SYSTEM DESIGN ._.fl Septic Tank Capacity (gallon) No l7.t./.4ig2Other /0 Percolation Rate (minutes/inch) Number of Bedrooms (or other) 3 i Required Absorption Area - See Attached Special Setback Requirements: /6 �r ir Date 7 Inspector Cra'P - FINAL SYSTEM INSPECTION AND APPROVAL (as installed) • Call for Inspection (24 hours notice) Before Covering Installation e , System Installer_ -- --- a - •� "' • - - -� Septic Tank Capacity /, n n 0 Septic Tank Manufacturer or Trade Name lO Septic Tank Access within 8" of surface VVv Absorption Area _ 5 9 . -. Absorption Area Type and /or Manufacturer or Trade Name f �, -. � .U Adequate compliance with County and Stat /requirements Other 2 a a �x�v o. /l o C c t1 �/ .-- e e( i • , `� , 1J . - t / Date /_. /� 9l Inspector 4• ��,� t ` ��^.V`-"n v 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. 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 ($500.00 fine — 6 months in Jail or both). ik White - APPLICANT Yellow - DEPARTMENT " INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPIJCATION OWNER _ d qR vs k, 1-1,5 it, Al , S /q Cfr O / Q C- I(' ADDRESS O 3 S n N Cr N R sot 1. 1441E PHONE .0 76 — f CONTRACTOR 0A/IC 4 I b ha N S ADDRESS 59 el! Coi ly Rnad N t G/RyT PHONE . 9F9 -o7 /c7 7 ca /o PERMIT REQUEST FOR (t4 NEW INSTALLATION ( ) ALTERATION ( ) REPAIR Atiach 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: Near what City of Town .S / IT Alf S A Size of Lot Legal Description or Address WASTES TYPE: (r) DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: l 11 Number of Bedrooms 3 b 6d too Yr1 S Number of Persons oZ ( ) Garbage Grinder 0s) Automatic Washer (u) Dishwasher SOIJRCE AND TYPE OF WATER SIJPPLY: kl WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Was an effort made to connect to the Community System? A site plan is required to be submitted that indicates the following MINIMIJM distances; Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOIJT A SITE PLAN, GROI IND CONDITIONS: Depth to first Ground Water Table / So t ett Percent Ground Slope 2 i`FYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (s ) , SEPTIC TANK ( ) AERATION PLANT ( ) VAULT ( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE ( ) MT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE ( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE FINAL DISPOSAL BY: ( ) ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION ()(3 UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER - DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? #O pF,RCOI.ATION TEST RESI II TS• (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) 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 purposed 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 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 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 perjury as provided by law. , . 5;4 Signed �;jp� i Date i' — /1 • PLEASE DRAW AN ACCURATE MApTO YOUR PROPERTY!! frild< 3 I rt... _ I) n _ / ,2;' / \t xa 0 ) C I k X c/ R & } 0 0 f m \b_. f ` & [ ` r 2 f •....4 0 2. co 0 co o 0 $ o 2 / \ ƒ§ § ne;a co „e° • Pp • // \ }i ® \ \} / § ... o E Z o .- 2 (\ . � \ o § § \.� / Cr 0 CO Et co ▪ 0 . r ®® 1, 0- \ CL \ CL s' ; 7‘c b = ""--- = . \ .'N 0 .1 m ,•'.ti Ict .., - \ _ t \ --r- . .s. •\ \ \ C S --c, . , , • , --- \, , ---- , \ , "- ., •• r, . . \ It it • b-e ':. I --,4 ---.. 1 ‘ , \---.....‘ 1 ,_,,,.- 5 _ .' \ 4._ ,...„ :i \ ., c_. _.t. --k, i \N ...,.. e-, —,— e- ... \ _ 4 \ C ,... \ \\ -....--..... \ , . ...... ' / \ , s 7 . 71,C.. .__.....1,_ C. C ( I , -, •Sr( 1. \ 2.' 4 g el 1 --.. 4 \ 1 Ce C, - . e) 7 yl ty fixoe (:* , i , es /7.077-c_ 4e.' /-intifte..or \ 1 _..._ L Lk I 62at An o 1.• 5 A ei-cznisti - , . • /ion area is figured as trench- bottom area and includes a statistical allowance for vertical side wall area. /Absorption area for seepage pits is figured as effective side wall area beneath the inlet. . Unsuitable for seepage pits if over thirty. o ce, 0 Unsuitable for absorption system if over sixty. Dwelling on less than two acres, areas of high water tables, or areas with a percolation test rate faster than 1" in 5 minutes must have alternative sewage facilities, i.e., central collection, holding tanks, individual treatment, etc. EXCEPTION: Absorption areas may be allowed with percolation rates faster than one (1) inch in five (5) minutes provided the soil is a sandy texture and no water table problems are encountered. 1. Maximum length of drainage line: 100 linear feet 2. Minimum width of drainage trench: 18 inches 3. Minimum spacing between trenches or pipes: 6 feet 4. Maximum grade of drainage lines: As level as possible 5. Minimum depth rock under drain PVC: 6" under PVC, 2" over PVC 6. Minimum depth of cover over distribution lines: 12 inches 7. Maximum depth of cover over distribution lines: Variable 8. Minimum grade of house sewer: 1/8 to 1/4" per linear ft. 9. Minimum distance of sewage disposal system from dwelling: 10 feet 10. Minimum distance of leaching area to a well: 100 feet 11. Minimum distance of septic tank to a well: 50 feet 12. Minimum distance of leaching area to a stream or water course: 50 feet 13. Minimum distance from septic tank and disposal field to property lines: 25 feet for drywell 10 feet for leach field 14. Minimum sewer pipe and distribution pipe: 4 inch diameter Septic construction should be of concrete, concrete block or of a material that will resist deterioration and which can be made reasonable watertight. Acceptable drain field pipe materials include plastic, terra cotta or concrete. If the house sewerline is longer than 10 feet between house and septic tank, a clean -out Y Should be installed as near as practical to the house. Septic tanks should be inspected once a year and cleaned when necessary. Cleaning is recommended when space between the scum accumulation and sludge residue on the tank bottom is less than eighteen (18) inches. • The Department recommends pumping a septic tank once every four (4) years when a yearly inspection by the owner is not practical. 7 4 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit 2671 109 8th Street Suite 303 Assessor's Parcel No. Glenwood Springs, Colorado 81601 Phone (303) 945 -8212 This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Owner's Name Orval & Elsie Sackrider Present Address 0350 Ingersoll Lane, Silt Phone 970 -876 -2246 System Location 0350 Ingersoll Lane. Silt Legal Description of Assessor's Parcel No. SYSTEM DESIGN Septic Tank Capacity (gallon) Other Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and /or Manufacturer or Trade Name Adequate compliance with County and State regulations /requirements Other Date inspector 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: 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 ($500.00 fine — 6 months In )ail or both). White - APPLICANT Yellow - DEPARTMENT . 4 9GG - �� /� Si7rp 1,2 a± 17 %g 06 /2 5 4, C? dcy/s a0 __ -- vs /8 /7 /b /r 8y�4 =- 3 = /*in, ,M6s I ao /w / x 3 ca9e7, ,LV 66 490 / s'91s.s o3, /9