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This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
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PERC CHARGE ONLY - FEE PD IN r 7Q .„.a D ° �{ Glenwood Springs, Colorado 81601
INDIVIDUAL SEWAGE DISPOSAL PERMIT NV 310 L . �� �
Owner
Lenard E. or Peggy J. ivie u
System Location Peach Valley Road - County Road 214
Licensed Contractor owner
' Conditional Construction approval is hereby granted for a / 0 gallon °''
Septic Tank or Aerated treatment unit.
ii Absorption area (or diapersal area) computed as follows:
Ifk Perc rate of one inch in /S minutes requires aminimum of /9 ' ft. of absorption area per bedroom.
1-
Therefore the no of bedrooms • 3 x _9O sq. ft; minimum requirement = a total of `' g. ft of absorption area. , ri ;, II
May we suggest S ea "9 C 6 e o /P' a z a r O c c F
Date I • .7 // 7 Inspector /N a U r.z L`E
G
FINAL APPROVF'L OF SYSTEM: • • 1"
4
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover-
ing any part.
Ifs
OC"' Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
° t Proper materials and assembly:
% !=� ?3arade • me of septic c tan or aerated treatment unit
II{ c /
4 Adequate absorption (or dispersal) area co, a • / -5 6 e / '/ 9 0 G
a '" Adequate compliance with permit requirements.
I
"`"� Adequate compliance with County and State regulations /requirements.
ry "I7 1
Other 7
Date // ! In spector
I ,1 �� � RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
. i ii
ii
s , "CONDITIONS:
II 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 66 -44.4, CRS 1963, amended 66 -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 violas
II Lion 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 In -.
iIII4 ,p volves a knowing and material variation from the term$ or specifications contained in the application of permit commits a Class 1, • a
Petty Offense ($500.00 fine — 6 months in jail or both.
Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
Fees Paid $5C)O
. INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date rk)() ll9
C' S^C - NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE - a S " " S '
U INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ,
11 Cps - 4�
Owner: - ; I D l� I. C 1 C CJ,
Mail Addresstef4 f 'j 4uo,'/ City: % / ,f12i a.1,7 - /C 0 'lip: A',97 Phone: 7�,�1 -, cey
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 t• t holes.
1. Location of facility: Count 11... "' ' _ City or Town firie ,4" 1/f //e y
Legal Descri tio O � � ' L L � I L ot Size 7 t
2. No. of Bedrooms ..? Septic Tank Capacity /000 Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well !/ Depth i// 4 ? , / �u ther Depth to first ground water table���Q,
4. Is facility within boundaries of � aa city /town or sanitation district? I
`P�
j
5. Distance to nearest sewer system: ��j OA- ; ` .
Have you attempted to arrange a connection with the system? 0 .! t
If rejected, what was the reason? jl ( 7Th---0 7Th---0 c.-G
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: c e- = =_ .'c�,
7. Name, address, and telephone of person who made soil absorption tests:
e= PC -12-u -I I
8. Name, address, and telephone of person responsible for design of the system:
Er
.--),---,---4).,,
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.
/ 4/7 A �
D e Si of Applican
(TO BE RETURNED TO HEALTH DEPT.)
9 i ` 7 -t1 7 >°&'
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY J L/ v ' /
(yid :t e ,
U loD /F / 1/
yI e— Y
� r �o re RT
/le /to v PF t'7 y
;'f R
• to 11
Y
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE RETURNED TO HEALTH DEPT.)
_ - r , Co. Clerk Form 10.
x t , � / COUNTY CLERK AND RECORDER OF GARFIELD COUNTY, COLO.
r / � .20 t 3. 125 - Glenwood Springs, Colo.,_L! ak_e. = _ 19 $ '---.
r r : , ,' PPPiUPh of `ZCJ�z � en �� ...
—
r
ieil ' _;�/L�Lttiv .c , 1 — ' - ez- — '"_ jC OLLARS
w; For Services es / Board of County Commissioners, .
'_ � For Ackn� 'ledgments,
!''. For_ij 4 -Z -- For
"� ' Total, °v
It, _
� ? Recorded and Countersigned by ,�� �� C _ - , tom -t�14� __County Clerk
,r • -
",",... Chairman Board Co. Comm. A Deputy County Clerk
-: na
.
atS P:i'i`}SIN A'TI NUE
GLESIWOUD SPRINOs COLORADO
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERIMIT
RECkaPT # /075
.t <;11c-•
OWNER . ..__ ADDRESS: ��J. TELEIti;t
CONTRACTORS 5, .P/ ADDRESS: ___ TEIEPHO:dZL__,
SITE LGCATZONsegmad V14/04 Pt NO, OF BE3)ROOMS:3 SIZE OF LOT t2 t r _ ,
B eim /I.v .nA- 9Ql...i- •»i oiwr-R yp
Application for an individual sewage disposal permit is hereby submitted, The
individual sewage disposal system will be constructed in accordance with the
regulations concerning individual sewage disposal systems within Garfield County,
This application is valid for six (6) months from date sign.,
Q ed ,
DATE: Ore �-;' ,97A, ti SIGNATUREs�..,j ' . g7. ��._... ._
!/
Perculation test results: __ _ Minutes per incht __��_
Recommended minimum size of leaching systems_ ____
Recommended minimum size of tank:
PLOT PLAN
DATE? SNITAR3AN:
•
605 P1'TKIN A"i'k u 3
GLENWOOD SPRINGS COLORADO
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERIM
RECE &PT 1/ /2
o WNERi - d ADDRESS: A -2- Sax .1.37
37 G - . S TELEPIZONEs 9
n o... ..
CGNTRACTOR: %S. a p ADDRESS: TFJ.FFHONEL__
SITE LOCATION: '' NO. OF BEDROO1Ss SIZE OF LOTSra., ,
)34/7 v at .. T7 n- a0g.4 .-- fin _0 J g
Application for an individual sewage disposal permit is hereby submitted, Tba
individual sewage disposal system will be constructed in accordance with the
regulations concerning individual sewage disposal systems within Garfield County,
This application is valid for six (6) months from date signed..
DATE: n �� .-e, .9 SIGNATURES g 0 0
Perculation test results: Minutes per inch:
Recommended minimum size of leaching systems
Recommended minimum size of tank:
PLOT PLAN