HomeMy WebLinkAboutApplication- Permit{ GARFIELD COUNTY DEPORTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue 4;12'
Glenwood Springs, Colorado 81601 ��� k"�'4k U,
PERMIT # S 064 (this does not constitute
a building or use permit)
Owner .C'. Ale
System Location , 'Iri/ 5.
Licensed Contractor. 2719 •' A/067' i)
* Conditional Construction approval is hereby granted for a 7.6— gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate f' inches in ..=;767 minutes SAP sq. ft.
absorption area per bedroom 7Uk
# of bedrooms t:;) x GP/C) sq. ft. minimum requirement •='-1.. - Pr-/"21-1-11r//j4/
May we suggest / 'h 36iA -5/ a3E0/1' .46741-t3
Date '7-
FINAL APPROVAL OF SYSTEM:
Inspector
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
ct Adequate absorption (or dispersal) area.
sdequate compliance with permit requirements.
(�Rdequate compliance with County and State regulations/requirements.
Date '7—_ _ 2. - 7' Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.44.4, CRS 1988, amended 88+14, CRS 1985.
2. This permit is valid only for connection to structures which have fully complied with County Zoning and
building requirements. Connection to or use with any dwelling or structures not approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the permit.
8. Section HI, 8.24 requires 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 con-
tained in the application of permit commits a glass 1, Petty Offense ($500.00 fine - 6 months in jail or
both.
Ippr., iRADO DEPARTMENT OF HEALTH
Water rclluti.on Control Division
44210 Fast llth Avenue
1 Denver, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM**
Owner: Sc 6
Mall Addrese (;303( 7I, City
A. INFORMATION REGARDING PROJECT SUI3MITTED.FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of arca, habitable buildings, location of potable water wells,
soil percolation test'holes, soil profiles in test holes.
1. Location of facility: County F414/ City or towni
Swif Ili EA' oA-seet"tj $1 -r or. GSlRowe 91W Hhe. 4t*,�Ce pal megi'Dr4n]
Legal description Roptic, Lot size_^ j,Ac
2. No. of bedrooms 4 Septic tank capacIty457 _ Aeration unit capRcity
3. Source of domestic water: Public (name):
Private: We11 x_DepthSzetOther Depth to first ground water table 3.S _ ..
4. Is facility within boundaries of a city/town or sanitat ion district?_���.�
5. )ts:er:cc to nearest sewer system:
Have you attempted to arrange a connection with the system?
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes per inch
of Clop in water level after holes have been soaked for 24 hours
7. Name, address, and telephone of person who.made soil absorption tests:
Afe
/1
8. Name, address, and telephone of person responsible for design of t:he. system:
L
.1141-rj---"Date
Signature of Owner
*Required by Article 66-28-12 (CRS, 1963, 1967 Perm. Sum.
**Required in areas which have been identified as areas in which danger of pollution
of waters of the State may occur (Art. 66•-28-8(5), CRS) and/or areas in which there
is no local septic tank ordinance.
B. SIGNATURES OF LOCAL OFFICIALS: The undersign .have reviewed the notification
described on the front of this sheet and recommend approval or disapproval of
the discharge as shown below:
Date
Comments:
Approval Ulsapproval
Signature for Local Health Department
Signature for City/Town Official CiiiTT)
Signature for County Official—TTitieT
Signature and 'title
Note: The Notifier (front of this sheet) must obtain comments and signature of at
least one of the above.
C; FOLLOWING FOR STATE HEALTH DEPAR1MENT USE: Recommendations of the 0!s rict Ergir:eer:
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP -33(13-72-2)