Loading...
HomeMy WebLinkAbout03112 AP x GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N= 3 k; e 109 8th Street Suite 303 Assessor's Parcel No. u . Glenwood Springs, Colorado 81601 5 a ) • ` Phone (303) 945 ; f .1 j This does not constitute i e 1 INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. y 4 ) � PROPERTY 1 f (lzz � r c Owner's Name h.\ Qcu , r AIrt) ^ Present Address { P hone S • 3 • System Location /i I ((S C7(1) 1 `" `� } : r 6 } Legal Description of Assessor's Parcel No. 1 ' S ,4 SYSTEM DESIGN /COO 7. 3 .P 4 "'1 } op 2So o� ‘1 , ' f ptic Tank Capacity (9 (gallon) Other 4. � Se Percolation Rate (minutes/inch) Number of Bedrooms (or oer 4 ' i i f B th > �; ( Required Absorption Area - See Attached y i Y Special Setback Requirements: ii t ! 5 ' Date inspector t K \ ) r c FINAL SYSTEM INSPECTION AND APPROVAL (as installed) \', Y 4 ° Call for Inspection (24 hours notice) Before Covering Installation System Installer © t-I.• -t E 1 ti :p t Septic Tank Capacity / 0 C) L ' 9 i sr , Septic Tank Manufacturer or Trade Name r : : Septic Tank Access within 8" of Surface i Absorption Area 3 2 C Ft A M 6 Ell S I M A CI E 0 ( L4 no.- S d F S rq) 't 'l t t L C /aC N C' , --// JAef OG� r S ` Absorption Area Type and/or Manufacturer or Trade Name !. • r < • f Adequate compliance with County and State regulations/requirements f, t ' ` SF C NC,n. P LA At 5 ! Other /� , I i ' Date Z` / - c 0 Inspector /7 A /`I 0 i 1 R ETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 't t o *CONDITIONS: 4 f 1? 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter P,! I ' 25, Article 10 C.R.S. 1973, Revised 1984. ,, t 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con - F F . nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a { i requ 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 s in a manner which involves a knowing and material ' ,, ) variation from the terms or specifications contained in the application of pe It } mmits a Class I, Petty Offense ($500.00 fine — 6 1 Y • i months in Jall or both). R- 4 ■ White - APPLICANT Yellow - DEPARTMENT • I T . • INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION OWNER_,__. �D n1Nt ADDRESS . - 17-03 I lh "> fl I O , G WS PHONE 'k 5 CONTRACTOR - 2A AN t W 15 ` / - ta-IC GRe/ � C.,0 s UClD ADDRESS Dt4G iiCt 'Z� Y QUA , 6V.).S PHONE AyS - PERMIT REQUEST FOR X 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). Near what City of Town _w • 1 �.. Ner. • r Legal Description or Address r't ETV v 6DUN - N 1Nbt'( Sue v& y WASTES TYPE: DWELLING ( ) TRANSIENT USE ( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: SI I"} G C C VL1 Wl I I V `- Number of Bedrooms (z tAit l I be P1 n h e c) Number of Persons 3 f Garbage Grinder 9() Automatic Washer (4 Dishwasher 5OI JRCE AND TYPE OF WATER SIMPLY; (\/ WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: s1' ttJC-4 DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: L("F> (2 rv't (6 e) / V(L LJ b t/ Was an effort made to connect to the Community System? lO - CSC) Y A site plan is required to he submitted that indicates the following MINIMUIM 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 YOIIR INDIVIDUAL, SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN, GROT IND CONDITIONS: i A Depth to first Ground Water Table 1 SS 9s Percent Ground Slope -j , 2 1 • • , TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (4 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 (i7 UNDERGROUND DISPERSAL ( ) SAND FILTER ( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND ( ) OTHER - DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? /YQ PERCOI.ATION TEST REST II .TS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) q Minutes A.. 30 per inch in hole No. 1 Minutes g per inch in hole NO. 3 Minutes (11 'W 1 per inch in hole No. 2 Minutes per inch in hole NO. _ Name, address and telephone of RPE who made soil absorption tests: S+ —mac. (rt cvwv4t 4,3 0.4 44.,, 113 q nth ST 9)o - 9`lS- �2.(So Name, address and telephone of RPE responsible for design of the system: '3 .e - L& ct,,..l. -rt and coat l/3 7" ST, 9 - 9ti'( 2550 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.p, C� Signed / 11 n 4WQOWlA/'. Date f 4 v. 23 j q 1 1 0 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! . --- '1i 03 3 de N._w / . t? _ ..___ .... ........ ... • • � ' ( / ° < [) \ � &® / { � \ / cn \ o _ [ 2 \ 2 k © Ft g ( & ^ \ \ / / ( I ` ir, � � \ \ c °: ��� / Q / fl 0 ` Z a \ \ / § IF § 0 \ § ( \ • \@ ai ® \� � �� r• 0 $ 3 2 \�C / \t: ' D � j ij A\ . f ) ` 9 0 \ 1. / {r ` / % 7—. xa // 2 § • / / A Li VI .. ___ .: /. . °® \ \\ V-§ fw& m.Z +4wA. - —k /* . JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS te n. PO. 9TH BO STREET, SUITE 214 ,(/ P.O. BOX 1450 GLENWOOD SPRINGS, COLORADO 81602-1458 . ; PHONE: X970) 945-2550 FAX: (970) 945 -1410 H.KgpI I N:A Wednesday, August 19, 1998 Thad Nieslank 7203 County Road 115 Glenwood Springs, CO 81601 RE: Percolation testing results. Dear Thad; As per your Jerome Gamba & Associates, Inc. performed Pecolation testing at the site as described above. The testing was performed on August 19, 1988. The new percolation testing was performed in hole just below the profile hole as shown on the Hepworth - Pawlak report dated July 23, 1998. The test holes were pre - soaked the night before testing. The results of the percolation testing are presented in the table below. The average percolation rate is 34 min/in. 4 This report has been conducted in accordance with generally accepted engineering principles and practices. The recommendation in this report is based upon the data obtained from the percolation testing. If conditions encountered during construction appear to differ from those described in this report, we should be notified at one to evaluate these soil conditions. If you have any further questions regarding the percolation testing, please contact us. Sincerely, Jerome Gamba & Associates, Inc. �,�/ M ie: Chris Strouse y / .me Gamba, P.E. Nieslanik Percolation Testing G: 198728 -21 thadperes. doc Page 1 of 2 • PERCOLATION TEST RESULTS FORM • DEPTH DROP in HOLE OF TEST THE MEASURE WATER PERCOLATION No. HOLE TIME INTERVAL MENT LEVEL RATE REMARKS (in) (min.) (min) (inches) (inches) (min/in) #I 58 8:56 18 5/8 9:09 0:13 19 1/4 0.625 21 9:20 0:11 19 3/4 0.500 22 9:30 0:10 20 1/8 0.375 27 9:50 0:20 20 5/8 0.500 40 10:10 0:20 21 1/8 0.500 40 10:38 0:28 21 3/4 0.625 45 #2 61 8:58 17 1/8 9:10 0:12 18 1/8 1.000 12 9:21 0:11 19 0.875 13 9:31 0:10 19 1/2 0.500 20 9:51 0:20 20 3/8 0.875 23 10:11 0:20 21 1/16 0.688 29 10:39 0:28 22 0.938 30 #3 50 8:59 19 1/4 9:11 0:12 20 1/8 0.875 14 9:22 0:11 20 7/8 0.750 15 9:32 0:10 21 1/2 0.625 16 9:52 0:20 22 1/2 1.000 20 10:12 0:20 23 1/4 0.750 27 10:40 0:28 24 1/4 1.000 28 ..• // . / L! . Nieslanik Percolation Testing G: 198728 -21 thadyeres. doc Page 2 of 2 JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS Form No. • OFFICE THE STATE ENGINEER OWNER S COPY GWS - 25 ' COLOOLORADD DIVISION DIVISION OF WATER RESOURCE�JYY'v (f 11 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 • • (303) 866 -3581 1095 • • WELL PERMIT NUMBER 719433 - -- APPLICANT DIV. 5 CNTY. 23 WD 38 DES. BASIN MD Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION GARFIELD COUNTY THAD NIESLANIK NE 1/4 SE 1/4 Section 34 7203 COUNTY ROAD 115 Twp 6 S Rng 88 W 6TH P.M. GLENWOOD SPRINGS, CO 81601 DISTANCES FROM SECTION LINES 2360 Ft. from NORTH Section Line (970)945 -5130 310 Ft. from EAST Section Line PERMIT TO USE AN EXISTING WELL ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of the permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402 -2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37- 92- 602(31(b)(11)(A) as the only well on a tract of land of ± 36.65 acres described as that portion of the S %, SE %, NE % and the N %, NE %, SE %, Sec. 34, Twp. 6 S, Rng. 88 W, 6th P.M., Garfield County. Reference attached exhibit A. 4) The use of ground water from this well is limited to fire protection, ordinary household purposes Inside up to 3 single family dwellings, the irrigation of not more than one (1) acre of home gardens and (awns and the watering of domestic animals. 5) The maximum pumping rate shall not exceed 15 GPM. 6) The return flow from the use of this well must be through an individual waste water disposal system of the non - evaporative type where the water is returned to the same stream system in which the well is located. 7) This well shall be located not more than 200 feet from the location specified on this permit. 8) Approved for the installation of a pump in, and the use of, an existing well, constructed on 08/20/98, to a depth of 187 feet, under monitoring hole notice MH- 34181, acknowledged 08/10/98. NOTE: Section 34 Is an irregular "SHORT" section (approximately 4900 feet North /South). ' -- i�6�8 APPROVED ' / D M W �� �• e 1 2� ,A 1 Receipt No. were glneer DATE ISSUED OCT 0 71998 EXPIRATION DATE OCT 0 7 2000