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HomeMy WebLinkAboutSystem Design ReportGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 401 Glenwood Springs, Colorado 81601 Phone (970) 945-8212 INIDIVIDUAL. SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name 4-5:011/77/ Present Address System Location_ ,_.7534i1//i-- Legal Description of Assessor's Parcel No. SYSTEM DESIGN 3© Septic Tank Capacity (gallon) Percolation Rate (minutes/inch) Required Absorption Area - See Attached Special Setback Requirements: Date !/f 7 Permit 4-73t_ Assessor's Parcel No. This does not constitute a building or use permit. Phone 35%- 5/ L Inspector Other Number of Bedrooms (or other) -3 sq, FT /AI C' cg �lidits s,:r;FT/it/LsE•7 -' E-cLs FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation /4094(477X/4/ 1/t//e,5-7— System Installer Septic Tank Capacity % tea' Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface , r Absorption Area _ ' - S � /� � f VCZ Absorption Area Type and/or Manufacturer or Trade Name -� i f-5— 0/ /Mr .36,5 Adequate compliance with County and State regulations/requirements Other • Date �r Z. - /7 _ Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 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 tor both legal action and revocation of the permit. 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