HomeMy WebLinkAboutPermitGARF I ELD CO U NTY B U ILD I I',I G AN D SAN ITATÍ ON DEPARTI'V4 ENT
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Phone(g7o)g45-s212Assessor'sParcell'lo.
IT"IDIVI DUAL S EWAGE DISPOSAL PERI'ÍIT
PROPERTY
Dr¡¡ner's I'Jame Addiess
This does not consiiiuie
a building or use permit.
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Sysiem Location
Legal Descripiion of Assesso;-'s Parcel No- 2 / Z3 Aó3 OO /3 {
sYSÏET.'/i DESIGN ì
. -¿-' dO 0 Septic TenkCapacity (gallon)
s- Percolalion Rate (minuies/inch) Number oí Bedrooms (or other)
Required Absoi'ption Area - See Atiached /+f -se, fl t í TRørc,{ + / z Q- lt
Oiher
ÒR/NSpecial.SeihackRequírements: /gO 9Q,Fr ^ßtrV +- /{ Q'It
o"r",t9-./B lnsPecior
SYST A (as ínsielled)
Cellfor lnspectíon (24 ho ur s n otice) Before Cove r-ing I nsta liation
Sysiem fnstalfer a
Septic Tank CaPaciíY
Septic Tank llanuíaciurer or Trade Name Run/
Sepiíc Tank Access within 8" oí suríace
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Type and/or l,4anuíaciurer or Trade Name
Absorption Area
Absorption Area ërF
Adequate compliance rlriih couniy anc staie regulaiions/requireme nis V)5 S
û -zz-/g lnspecior
RETAIN I¡/ITH RECEIPT RDS AT CONSTF.UCTION SITE
CONDITIONS:
1. All insiellation must comply wíih all requíremenis oí the Coforado Staie Boaici of Health lndividual Sel'¡age
Disposal systems chapter 25, Ariicle 10 c.R.S. 1973, Re'¡ised 1984.
2. This permii is valid only for connec'iion to structures v¿hích have fully complied wiih Couniy zoning and
building requiremenis. Conneciion to or use lvíih any dwelling or structures noi approved by the Building and
Zoning ofíice sha¡ automaticalfy be a violation or a requiremeni oí the permíi and cause for both legal action
and revocatíon of the Permít.
3. Any person who constructs, altei-s, or ínstalls an individualselvage disposal system ín a manner v¡hich
involves a knowing and maieríal variation from the terms or specifÌcatíons coniained in the applicaiion of
permii commits a Class 1, Petiy Ofíense (S500.00 fine - 6 nronihs in jail or boih).
Oiher
Date
Whäe -APPLICANT Yellov¡ - DËPARTtulËNT