HomeMy WebLinkAboutSystem Design SpecsINDIV¡DUAL SEWAGE DISPOSAL PERMIT
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Glen,¡¡ood Springs, Colorado B1 601
Phone (97O) 945-8212
Presurrt Adciress 3
Permît 5/fs-
AssessoT's Parcel No
This does noi constituie
a building or use permit.
ZA4 CR.Z/4 Phone 7a7-atøZPROPERIY
Or¡¡ner's Name
Sysiem Location
Legal Descripiion of Assessor's Parcel No
SYSTEM DESIGN
e Septic Tank CaPacitY (galion)Oiher
3 fS Percolaiion Raie (minuies/inch)Nurnber oÍ Bedrooms (or other)3
þ9a -s4¿, fr ¡r/ flsøefl *'fs
Required Absorption Area - See Attached
Special Seiback RequÏrerirents:
aß.
7-f6 sq, Fl /r{ FEP * ê3
lnspector
(as installed)
4**'
4"*=
Date
c PS
hours noti ce) Before Covering lnstallation, Gall for lnsPection (24
SYsiem lnstaller
Sepiic Tank CaPacitY
/f,tptr ¿leç ¿:ê
Septic ïank Manufacturer or Trade Name
Sepiic Tank Access wiihin 8' of surÍace
Absorption Area ê _s
Absorption Area Type andlor Manufacturer or Trade Name
Adequate cornplia n ce uriih County and State reg ulations/requireme nts
Oiher
Daie -.f-lnspecior
ë
RETAINWITHRECEIPTREOORDSATCoNSTRUCTIoNSIÏE
C0NDITIONS: ---r^ ^r*ha r-
1'Aliinstallaiionmustcomplywiihallrequírementsof-tirejoloradoStaieBoardofHealihlndívidualSewage
Disposal Sy'iutt Cnapier 25' Article '10 C'R'S' 1973' Revísed 1984'
2. This pennit isvalid only for connection to structures which have fully complied urith county zoning and
building ruquir",-nrnts. connection to or use v.¡iih any dwelling or structures not approved by the Building and
zoningoffice shall automaticall y be aviolaiion or a requirement of the permii and cause for both legal action
and revocation of the Permit'
3. Any person Who consiructs, alters, or insialls an individual sewage disposal system ín a manner which
involves a knowíng and maierÍal variation from the terrns or specifications contained in the appfication of
permit ,o*rirr'u älass 1, peity offense ($500.00 fine - 6 months ín jaíl or boih)'
Whäe - APPLICANT Yellow - DEPARTkIÊNT