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Glenwood springs, coroîuJo'äroor Permit g7 G
Phone (g7o) 945-8212 Assessor's Parcel No'
INDIVIDUAL SEWAGE DISPOSAL PERMIT This does noi constitute
a buifding or use permit.
PROPERTY
Owner's Name c e PresentAdd
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Phone {7ø ^zæ
System Locaiion
Legal Descripfion of Assessor's Parcel No'21A
(as installed)
Callfor lnspection (24 hours notice) B efore Covering I nsiallation
Sysienr lnstaller
Sepiic Tank CaPacíiY'
Sepiic Tank Access wiihin B" of surface
Absorption Area
Absorption Area Type andlor Manufacturer or Trade Name
Adequate compliance wiih County and State regulations/requirements
Septic Tank Manufacturer or Trade Name
5
Oiher
Date
ê
-f-7 lnspecior
RETAIN WITH RECEIPT RE RDS AT CONSTRUCTION SITE
CONDITIONS:
1. A' instaraiion must compry wiih arr requirements of the_cororado state Board of Hearth rndividuar sewage
Disposalsystemscnapiei2S'Articlel0C'R'S'1973'Revised19B4'
2.Thispennitisvalidonlyfor"onn""tiontostructureswhichhavefullycompliedwithCountyzoningand
building requirements. connection to or use u¡ith any dwelling or structures not approved by the Building and
Zoning office shall automatically be a violatîon or a requiremãnt of the permit and cause for both legal action
and revocation of the Permit'
3. Any person who consiructs, alters, or installs an individual sewage disposal system in a manner which
involves a knowing and materíal variation from the terms or specifications contained ín the application of
permit commits " ó1"r, 1, petty offense ($500.00 fìne - 6 months in jail or both)'
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