HomeMy WebLinkAbout00250 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
I 2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERC FEL 4AIVED, RATE KNOWN PERMIT # Me. (this does not constitute
a building or use permit)
Owner Dale R. Titus
System Location Filing 2, Lot 30, Westbank Subdivision
Licensed Contractor
* Conditional Construction approval is hereby granted for a 1.2F0 gallon
Septic Tank or X Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pero rate 1 inches in s; mints 195 sq. ft.
absorption area per bedroots 4 :.. four
11 of bedrooms 4 x 125 sq. ft. minimum requirement. SOD sq, ft. of absorption area
May we suggest deep field 12' squj +re and 12' deep
Date ,. f Inspector
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.
e c! Septic Tank cleanouti within 12" of final grade or aerated access ports above grade.
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4 Proper materials and as a bly. 4° ��° Z
r
iL /. Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements:
Date � /97 Inspector _
ETAIN 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 1963, amended 68.3.14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County Zoning and
} building requirements. Connection to or use with any dwelling or structures not 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 permit.
3. Section III, 3.24 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-
mined in the application of permit commits aClass I, Petty Offense ($500.00 fine • 6 months in jail or
both.
Fees Paid t
INDIVIDUAL SEWAGE DISPOSAL APPLICATION
• Date . - 2 -
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM_
Owner: One 1, T P Tus
Mail Address: (30,' 3.1 City 4A tiaitit gAtft i. Zip: y / /,p/ Phone:A/c'»0
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 percola-
tion test holes, soil profiles in test holes.
1. Location of facility: County C ,9 f e j p City or Town N EA Et csLFN w oob
Legal Description WFSTI3pt4K - F, ,, .,247 Size !PK NG RE s
2. No. of Bedrooms 4! Septic Tank Capacity Aeration Unit Capacity '/ c v
3. Source of Domestic Water: Public (name): 'VIE s T BA wRTE Q g 3/57 M
Private: Well Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? A' o
5. Distance to nearest sewer system: ? 5-/-1?/'
Have you attempted to arrange a connection with the system? Of r
If rejected, what was the reason? i1f4 c
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: - -
7. Name, address, and telephone of person who made soil absorption tests:
/Jr�uZr
8. Name, address, and telephone of person responsible for design of the system:
9. Express permission is hereby granted for the inspection of the above property by any
member of the Garfield County Environmental Health Department and /or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Environmental Health Department.
10. I have been given an opportunity to read the Individual Disposal Systems Regulations of
Garfield County and I hereby agree to comply with all terms, conditions and requirements
included therein.
F E 6 ;19' 7 6 & 2, o f Owner
(TO BE RETURNED TO HEALTH DEPT.)
• PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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24.2'
3•74.r
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1,oT 313
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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41 1 7
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(TO BE RETURNED TO HEALTH DEPT.)