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, I \ GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit I'4 3227 F,
I L • 109 8th Street Suite 303 A ssessor's Parpel No.� f
i Glenwood Springs, Colorado 81601 t • s „ /�0 i r Phone (303) 945 -8212 ,
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a F This does not constitute P 1
a l INDIVIDUAL SEWAGE DISPOSAL. PERMIT a building or use permit. g' .
j PROPERTY a a t {
0 lnaki(Af DCcn Pr sent Address Po ooy c oat, 1140 ( 44 / �o ' e 1 59 i
Owner's Name
r ` 001 o m ra4 d r rra11, 11 (� Co.�icocl
System Location
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B s L egal Description of Assessor's Parcel No. — b f
i t ,CP - O∎rI%0St,�S t$ A E-�
a " SYSTEM DESIGN O t1
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! Septic Tank Capacity (gallon) Other
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i ) 9m In / Percolation Rate (minutes/inch) Number of Bedrooms (or other) - ` /1 6eo'( f'C.„
Required Absorption Area - See Attached e 4- L " �eX ( r r s
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R Special Setback Requirements: ,.
i' • 4'
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f Date — Inspector
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t y FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
f , Call for Inspection (24 hours notice) Before Covering Installation ; i
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9 System Installer (7 w N (n.
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t Septic Tank Capacity 1 (' U 0 6 1 - - - - -- • t •
Septic Tank Manufacturer or Trade Name C 0PLLkN✓0 " •
i Septic Tank Access withim8" of surface k `
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• Absorption Area 3 k{ ' `I U N 1 1 S I u A b C 0 s
(S I O , I) I r F (i S Ent i;
• ' Absorption Area Type and/or Manufacturer or Trade Name A S , ,
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• 4 Adequate compliance with County and State regulations/requirements 4
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f 1 Other i r
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Date lb— L{- 9 { Inspect A w N( o ; i
{ r RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
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f, •CONDITIONS: 6;
v 1. All installation must comply with all requirements of t Colorado State Board of Health Individual Sewage Disposal Systems Chapter 1
25, Article 10 C.R.S. 1973, Revised 1984. '
1 > 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 anydwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a e
• requirement of the permit and cause for both legal action and revocation of the permit. ,, ,
ii i 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material ?^
• F variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (8500.00 fine — 6 y'
i. months in )ail or both). �
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INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER D AA„Z int 47,414U
ADDRESS Po, Boy (a/ On Ormn1ne)4-1329 7p_ PHONE q fs9 -2100 c/
CONTRACTOR l /lI E/N C A- TZ E 211- 7
ADDRESS PHONE
PERMIT REQUEST FOR (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::
Near what City of Town ,4j Ftl CA t Size of Lot /0 � 2-00 sa
Legal Description or Address _ 6 3 LOC < t U Z r •/ia :.. _sra o
WASTES TYPE: (L4ISWELLING ( ) TRANSIENT USE Tom
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: go�.r
Number of Bedrooms (I�CJ� Number of Persons Z
( LK Grinder ( 4- Washer ( 4–Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: 'Thaw o F /vi= 7U�A L
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System? 1
A site plan is required to be submitted that indicates the following MINIMUM 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 WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table UNKNOWA/
Percent Ground Slope O — 4-71 o
2
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( VI:SEPTIC TANK ( ) AERATION PLANT ( ) VAULT
( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE
( ) CHEMICAL TOILET ( ) OTHER - DESCRIBE P) SSI13LE TNFI .7r4,+7vr2_
FINAL DISPOSAL BY:
( VrABSORPTION 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? A- 0
PERCOLATION TEST RESULTS: (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: Et 1 &EO Y cc f
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 ap 'cation and in legal action for perjury as provided by law.
Signed J// <' Date
PLEASE DRAW AN ACCU.ATE MAP TO YOUR PROPERTY!!
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H len G Co Hepworth - Pawlak Geotechnical, Inc.
� o��l ■
f Coonty Road
Glenwood Springs, Colorado 81601
Phone: 970.945 -7988
Fax: 970-945-8454
hpgeo @hpgeotech.com
August 24, 1999 ����kt' >t
P�
Dan Makufke
P.O. Box 621
New Castle, Colorado 81647 Job No. 199 666
Subject: Percolation Testing, Existing Residence, 0076 Commanchero Trail,
Elk Creek Subdivision, Garfield County, Colorado.
Dear Mr. Makufke:
As requested, Hepworth - Pawlak Geotechnical, Inc. performed percolation testing
at the subject site. We understand the existing septic disposal system has failed and
a replacement system will be required.
Percolation tests were conducted on August 20, 1999 to evaluate the feasibility of a
infiltration septic disposal system at the site. Percolation test holes were excavated
about 15 to 25 feet northeast of the existing house and presoaked with water by the
owner on August 19, 1999 at the locations shown on Fig. 1.
The test hole excavations consisted of one V- shaped pit dug to multiple steps from
3 to 12 feet in depth. The soils exposed in the pit consisted of 2 feet of topsoil
overlying siltstone /sandstone rock fragments. No free water was observed in the
pit to its total depth of 12 feet. The percolation tests were conducted in hand dug
holes at various depths within the pit and the results are summarized on Table I.
Tests 1 and 4, performed between 3 and 4 feet, averaged 15 minutes per inch.
Tests 2 and 3, performed between 5 and 7 feet, averaged 3 minutes per inch.
Based on the subsurface conditions encountered and the percolation test results, an
infiltration type septic system should be feasible at the tested site.
Dan Makufke PRE"
August 24, 1999 PRE
Page 2
If you have any questions or require further assistance, please call our office.
Sincerely,
HEPWORTH- PAWLAK GEOTECHNICAL, INC.
Louis E. Eller
,.� flcG7S
y 'y .J4.`Y it •
Rev. By: DEH cz 24443
LEE /sd /ksm .O � o . • •
SciStetirtV
HEPWORTH - PAWLAK GEOTECHNICAL, INC.
TABLE I PAGE 1 OF 2
PERCOLATION TEST RESULTS JOB NO. 199 666
HOLE NO. HOLE DEPTH LENGTH OF WATER WATER DROP IN AVERAGE
(INCHES) INTERVAL DEPTH AT DEPTH AT WATER PERCOLATION
(MIN) START OF END OF LEVEL RATE
INTERVAL INTERVAL (INCHES) (MIN. /INCH)
(INCHES) (INCHES)
P -1 43 15 10 3/4 7 1/2 31/4
7 1/2 6 1 1/2
6 4 1/2 1 1/2
4 1/2 3 1/2 1
water added 11 9 2
9 71/2 11/2
71/2 6 11/2
6 41/2 11/2 10
P -2 73 5 91/2 81/2 1
8 1/2 7 1 1/2
7 5 1/4 1 3/4
5 1/4 3 1/2 1 3/4
31/2 2 11/2
water added 141/2 121/4 21/4
12 1/4 10 2 1/4
10 8 1/2 1 1/2
8 1/2 7 1 1/2
7 5 1/2 1 1/2
51/2 4 11/2
4 2 v? 11 (2 3 ...
HEPWORTH - PAWLAK GEOTECHNICAL, INC.
TABLE I PAGE 2 OF 2
PERCOLATION TEST RESULTS JOB NO. 199 666
f HOLE NO. HOLE DEPTH LENGTH OF WATER WATER DROP IN AVERAGE
(INCHES) INTERVAL DEPTH AT DEPTH AT WATER PERCOLATION
(MIN) START OF END OF LEVEL RATE
INTERVAL INTERVAL (INCHES) (MIN. /INCH)
(INCHES) (INCHES)
P4 81 5 103/4 61/4 41/2
6 1/4 3 1/2 2 3/4
3 1/2 2 1 1/2 4
water added 9112 41/2 5
4 112 3 1/4 1 1/4
3 114 2 1 1/4
water added 9 1/2 5 3/4 3 3/4
5 3/4 3 1/2 2 1/4
3 1/2 2 1/4 1 1/4
21/4 1 11/4
P4 52 15 10 1/4 7 3/4 2 1/2
7 3/4 5 1/2 2 1/4
5 1/2 4 1 1/2
4 31/4 3/4
3 1/4 2 1/2 314
2 112 1 3/4 3/4
13/4 1 3/4 90
Note: Percolation tests were performed on August 20, 1999.