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HomeMy WebLinkAboutSystem Design SpecsINDIVID UAI. S EWAGE DISPOSAL PERMIT PROPER] Y owner,s Name As | *,/ c/ø/c,t{-preseniAdd rut,Ø @enone 45*á ffle / Glenwood Springs, Colorado 81601 Phone (s70)945-8212 O5'3 Pze3 Other Permlt rc (€ c-/ Assessor's Parcel No This does not constiiute a buílding or use permit. Sysiem Location Legal Descripiion of Assessor's ParcelNo SYSTEM DESIGN / oap FTNAL SYSTEM INSFECTION AND APPROVAL (as instalted) callfor lnspection (24 hours notice) Before covering lnstallation Septic Tank CaPacitY (gallon) +Percolation Rate (minuies/inch)Number oÍ Bedrooms (or oiher)5 Required Absorption Area - See Attached 37s-sq" lT¿t{ ß¿¡ruy* 33 @-*=êK Special Setback Requirements:+4 5€, ,rl //1/ÉEP f +å a-4-= Date lnspector ñ'1 lz,/tz.çonf +EEPRaar'4 ezt{ 8,<c¿K ASystem lnstaller Zsz GÁLSepiic Tank CePacítY Septic Tank t\4anufacturer or Trade Name .(/a R¿r>Zs c e Sepiíc Tank Access within 8" of surface s' Absorptíon Area a Absorptíon Area Type andlor Manufacturer or Trade Name Adequate complíance wiih county and siate regulaiions/requirements T-s 6? 5- Other Date n s-* /X'lnspecior RETAIN WITH RECEÍPÏ RDS AT CONSTRUCTION SITE CONÐITIONS: I . AII ínstallation must comply wiih all requirements oÍ the Colorado State Board of Health lndívidual Sewage Disposal systems chapter 25, Article 10 c.R.s. 1973, Revísed 1984. 2. This permit is valid only for connection to structures which have fulfy complied with County zoning and buílding reguirements. Connectíon to or use wíth any dwelling or structures not approved by the Buifding and Zoning ofiTce shafl automatically be a violatíon or a requirement of the permit and cause for boih legal action and revocaiion of the Pennit' 3. Any person who constructs, afters, or insialls an índivídual sewage disposal system in a manner which involves a knowing and materíalvaríation from the terms or speciÍications contained ín the application of permít commits a Class 1, Petty Offense ($500.00 fine - 6 months in jaíl or both). White - APPLICANT Yeflow - DEPARTMENT + F/rPKeeK / z {o GAL. Z4r,/K- 4b0 .s€, ff //1f ftørr/c.Y * sZ e^ />eK5rz s€, fl /^r øøP r /þ q.- 4s