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Final System Inspection & Approval 10.01.2015
This does not constitute a building or use permit., (Atit-It l -U t,vuiv .� ••••• •• • 108 Eighth Street, Suite 401 Glenwood Springs, Colorado 81601 Phone (970) 945-8212 INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name System Location 02_91,AAlf) 54 Al Legal Description of Assessor's Parcel No. SYSTEM DESIGN /oa Q Septic Tank Capacity (gallon) Other QPercolation Rate (minutes/inch) Number of Bedrooms (or other) 7 -- Required Required Absorption Area - See Attached Setback Requirements - Permit Assessor's Parcel No. Present Address Al- 6 7 c e S� Phone 2 /35 73 Oo 20 3 '0,3 SQ,� // % ,CNc- � Q4-, Special 5-(),f� psi .54P �` Z (0 <314--.s. Date q+/ / Inspector /'�/�©/f FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for inspection (24 hours notice) Before Covering installation /off yes Absorption Area b 3 5-4') , r 7 / Ai System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Type and/or Manufacturer or Trade Name - diff'/7 OC 4 - -. Adequate compliance with County and State regulations/requirements Other Date /a - Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE y,5 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. Connection 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 permif. 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 1, Petty Offense ($500.00 fine - 6 months in jail or both). White - APPLICANT Yellow - DEPARTMENT