HomeMy WebLinkAboutEngineered System Required 03.15.2018GAR F' ELD ""
r^îo? 9JL?li :,äi :lHti, o N D E'ARTM ENr
Glenwood sprinss, ctråî"ã"'ãìoor Permii {eS-æ
Phone (970)945-8212 Assessor's Parcel No'
INDTVIDUAL SEWAGE DISPOSAL PERIJIIT
PROPERTY
'Owner's Name PresentAddress
This does not consiitute
a building or use rmit.
PC.I/ phone Z7a'-oá47
System Location
Legal Description of Assessor's Parcel No'
SYSTEM DESIGN
2-/7Ça {za z plz
leAA Sepiic Tank Capacity (gallon)Other
/A--A1gø-Pe rcol ation Rate (min utes/in ch )
Required Absorpiion Area - See Attached
SPecial Setback Requirements:
Number of Bedrooms (or other)z
êDaie ; -lnspecior ,/.r.74 tú¿-t Ur/
(as installed)
Callfor lnspection (24 hours notice ) Before Covering lnstallation
Sysiem lnstaller
Sepiic,îank CaPacíiY
Septic Tank Manufacturer or Trade Name
Sepiíc Tank Access r¡¿ithin 8" of surface
Absorption Area
Absorption Area Type andlor Manufacturer or Trade Name
AdequatecompliancewithCountyandStateregulaiions/requirements
sFEr4 ¿tþ,ç,PS øl/A
Other
Date lnspector
RETAINWITHRECEIPTRECORDSATCONSTRUCTIONSITE
GONDITIONS:
r. Ail instailation must compry wíth ail requirements of the cororado state Board of Hearth rndividuar sewage
DisposalsystemsCnapiei2S'Artícle10C'R'S'1973'Revised19B4'
2.ThispennitisvalidonlyforconnectiontostructureswhichhavefullycompliedwithCountyzoningand
building requirements. connection to or use v'¡ith 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 legaf actíon
and revocation of the Permit'
3. Any person who consiructs, alters, or installs an individual sewage dísposal system in a manner which
involves a knowing and materíal variation from the terms or speciflcations contained in the application of
permit commits " ó1"r, 1, petty offense ($500.00 fine - 6 months in jail or both)'
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