HomeMy WebLinkAbout00087 9 - 7 - 1 �
9 )
0 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
N I Glenwood Springs, Colorado 81601
4
PERMIT fl S ow (this does not constitute
a building or use permit)
1 Owner Albert L. Stark
IE
System Location Lot No. 5, Oak Meadows Subdivision
° ul Licensed Contractor KLM Construction
* Conditional Construction approval is hereby granted for a /Seer gallon
I I; _ Septic Tank or Aerated treatment unit.
rylui Absorption area (or dispersal area) computed as follows:
Pere rate / inches in 30 minutes .25•Q sq. ft.
absorption area per bedroom .alas'
'„ 11 of bedrooms_,C_ x ..zs-a sq. ft. minimum requirement= /, ero SQ # 77 d, F �asagen,
May we suggest e 97'zcsove 1 6,5 -1 Betvw .cefc, e sr—,NE,
•
Date /4 —J- v'W Inspector � - ' j
FINAL APPROVAL OF SYSTEM:
No system shall .be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
l�K .4e,e�tr�o
Septa' Tank cleanout to within 12" of final grade or aerated access ports above grade.
/, zSY 64 -e, n/ el atoll/ Te L*n t
Proper materials and assembly. 772eseernionV r emir /n/
(9•? Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
4< Adequate compliance with County and State regulations /requirements.
Date l/ - 1/ " 7,/ Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.444, CRS 1968, amended 66.8.14, CRS 1968.
2. This permit is valid only for connection to structures which have fully com lied with County Zoning and
building requirements. Connection to or use With any dwelling or structurff approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the p ermit../
8. Section HI, 8.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine • 6 months in jail or
both.
9OLORADO DEPARTMENT OF HEALTH
Water Pollution Control Division
4210 East Ilth Avenue
Denver, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: 9.A1.e1 L.. SSfl9As
Mall Address ex /J7y /ekarry R/) ,c4Clty40%) a Zipg /(,a, Phone.U$ a
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of area, habitable buildings, location of potable water wells,
soil percolation test holes, soil profiles to test holes.
1. Locetion of facility: County el .City or town C6'M 57/51"
Legal description jig' Ar Lot size y/, aC ACRtS
2. No. of bedrooms .5" Septic tank capacity /a?p Aeration unit capacity
3. Source of domestic water: Public (name): //2/0$1711
/
Private: We11JDepthVO Other Depth to first ground water table 4/(/
4. Is facility within boundaries of a city /town or sanitation district? /OQ_
5. Distance to nearest sewer system: Lei A.
Have you attempted to arrange a connection with the
/ ^^ system? W A •
If rejected, what was the reason? N I^1.
6. Rate of absorption in test holes shown on the location map, in minutes per inch
of drop In water level after holes have been soaked for 24 hours _ •
r7 PF? ?.t 4 t T
7. Name, address, and telephone of person who made soil absorption tests:
se Pnu.t
8. Name, address, and telephone of person responsible for design of the system: -__
sea: il=1441i
Date Signatu e •f Owner
*Required by Article 66- 28- 12(CRS, 1963, 1967 Perm. Sum. Supp.)
* *Required in areas which have been identified as areas in which danger of pollution
of waters of the State may occur (Art. 66- 28 -8(5), CRS) and /or areas in which there
Is no local septic tank ordinance.
i i
•. r
B. SIGNATURES OF LOCAL OFFICIALS: The undersigned have reviewed the notification
described on the front of this sheet and recommend approval or disapproval of
the discharge as shown- below:
Date Approval Disapproval
Signature for Local Health Department
Signature for City /Town Official (Title)
Signature for County Official (Title)
Comments:
Signature and Title
Note: The Notifler (front of this sheet) must obtain comments and signature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer:
•
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP- 33(10 -72 -2)