HomeMy WebLinkAboutApplication- Permite
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL MEAL C3L".3- _
•` 2014 Blake Avenue / L' -u"-4- a4 --1`b
Glenwood Springs, Colorado 81601 0 ,_.,
PERMIT #8 '065 this does not constitute
el -1-1 (9 6na, a4�a building or use permit)
I.-tz imp..
j
System Location i_O- 3 f1 � .�,- cA =- i(0' t ' < <_.l t ' y`t
Owner
Licensed Contractor CSW A/Ar-i
2"J rLL� r
* Conditional Construction approval is hereby granted for a 7-6r4> galloni;i.✓i,,,7
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in /.5 minu4es\ /9';'' sq. ft.
absorption area per bedroom 1`4414 )
# of bedrooms Q x /9a sq. ft. minimum requirement -.: 31?r7.SQi'rc7/4: .A1r3 ,,-',, '761,(1
May we suggest/„?'A,AD1 3 . .d i9 ,,sr r5
Date - "
Inspector
FINAL APPROVAL OF SYSTEM:
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. f .0 S
figeet
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date
Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. AU installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.44.4, CRS 1963, amended 66.3.14, CRS 1963.
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 riot 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.
3. Section III, 3.24 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 Class I, Petty Offense ($500.00 fine - 6 months in jail or
-__ _
both.
KLORADO DEPARTMENT OF HEALTH
Wa*trr Pollution Control Division
j 021Q East lith Avenue
Denver, Colorado 80220
Owner
Mail Address:Q 9, a3- ^ Cl tyZI pU5Z Phone/25..V
A. INiT RMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, tocography of area, habitable buildings, location of potable water wells,
soil percolation test holes, soil profiles in test holes.
Afew eEs r
1. Location of facility: Coun V City or
Legal description d _ l7Lot size
2. No. of bedrooms Septic tank capacity 10 Aeration unit capacity.-----,
3. Source of domestic water: Public (name):
Private: Well XDept Other. ------Depth to first ground water table,, t
4. Is facility within boundaries of a city/town or sanitation district?Q
5. Distance to nearest sewer system: ,..3'//,�s
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SWAGE TREATMENT SYSTEM**
AAdee--+
Have you attempted to &'rrange 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 drop In water level after holes have been soaked for 24 hours
7.
7 -
Name, address, and telephone of person who made soil absorption tests:
8. Name, address, and telephone of person responsible for design of the system:
?4,<A7 /la 7/277 0/1,÷1 a
re of Owner
*Required by Article 6t-2&-12(CRS, 1963, X967 Perm. Sum. Supp.)
**Rilquired 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
lr, no local septic tank ordinance.
B. SIGNATURES OF LOCAL OFFICIALS: The undersigned have reviewed the notification
described on the front of this ---sheet and rccomMen6 approval or disapproval of
the discharge as shown below:
Date Approval Disauloval
Comments: '
Signature for Local Health Dmpartn*nt
Signature for C|ty cw' Officio; 7[)�i�l
Signature and Title
The NotMcr (front of this sheet) must obtain comments and signature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTHDEPARTMCNT USE: Recommendations of the District Engineer:
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP -33(10-72-2)