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Home My WebLink About00364 This does rot constitute . a building or use permit. Hi GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue AL I ,� lOI \} Glenwood Springs, Colorado 81601 3� kC,QA I F c �C otot_ 9 INDIVIDUAL SEWAGE DISPOSAL PERMIT N:' 364 Owner rxee.4 " /.G..4. B" A"e-is fryten• • System Location "Cr: / "NV Z- L. Sr 1.3rf / Gc-'r Y.7 /1-7 /7.) Licensed Contractor Set Orr „M-'l /V 0/' .SPa/fi' "^ t3 #t' 6iC - /fi:54 Conditional Construction approval is hereby granted for a gallon Septic Tank or Aerated treatment unit. ill Absorption area (or diapersal area) computed as follows: Perc rate of one inch in .r 1.e minutes requires a minimum of a S O sq. ft. of absorption area per bedroom. Therefore the no of bedrooms — x .aSO sq. ft minimum requirement = a total of i46.0 sq. ft of absorption area May we suggest /a / Jt 3S 1 ,1( 3 ".5 e!7mi>•r✓a •Go e r c- Date Fj P . /0 / 977 Inspector � (/.a X r X 8 " S [R' -W.Q7 c- .Cs ' u.'cau c-0 a G / - .e -c..` / /a Ut=- /sew �a>�+ FINAL APPROVAL OF SYSTEM: !i� �;--�? .- ..5 i � a �. - svr tr /t!s '2.c, f>Sel+< N r ?re. .r--tu tateol c) ervat No system shall be deemed to be in compliance with the Sewage Disposal Laws un I theassembled system is approved prior to cover- ing any part. e Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. /, 000 4 fl . -. acs - At , 77 c Titl[/ic. '.. �// a ' Proper materials and assembly. % 4 s n,,- -w e . • etoel'-r Trade name of septic tank or aerated treatment unit. Ze Adequate absorption (or dispersal) area. M Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. Other Date J ^' // 77 Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE "CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, a'hopted pursuant to au- thority granted in 66-44-4, CRS 1963, amended 66-3-14, CRS 1863. 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 viola - tion of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Section 111, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in- volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or both. Building Official - Permit White Copy Applicant - Green Copy Dept. - Pink Copy Fees Paid $,:D`Y' INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date c ,1 —/o - -77 NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE 412r- , g, INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM Q to _ PC2c ovo) --1 Owner: O r v // e /1 v s 4 e r —° Mail Address: /H /30x 7_A' City: /I; e Zip: ,¢ /G co Phone: 6.xr -isve 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 ('7. !J•,,c=Z/c City or Town ;i /c 7 z IQ1c c - Legal Description �Gprl -PA Lot Size �. l� / c= . : , r 2. No. of Bedrooms d Septic Tank Capacity 7 J Aeration Unit Capacity 3. Source of Domestic Water: Public (name): 05( r`? (Z{ F- (,. Private: Well Depth Other Depth to first ground water table 4. Is facility within boundaries of a city /town or sanitation district? No V 5. Distance to nearest sewer system: - 7 C7 1 :: Have you attempted to arrange a connection with the system? ,C0(c r: If rejected, what was the reason? 6. Rate of absorption in test holes shown on the location map, in minutes per jnch of -, drop in water level after holes have been soaked for 24 hours: c �. Pc 7 a nI'T 7. Name, address, and telephone of person who made soil absorption tests: Pc/2424 7 8. Name, address, and telephone of person responsible for design of the system: 5( / 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. /e? - 7 7 - � ` e l: 7 , !/Jc.e- !._6L r Date Signature of Applicant (TO BE RETURNED TO HEALTH DEPT.) PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY • Co t__ _ _ %or C l" 1 C INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES CI 1 1 cu is rt t A D i Iz- 'I, {G- Fi -TICi.) (TO BE RETURNED TO HEALTH DEPT.)