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HomeMy WebLinkAbout00376 This does not constitute a building or use permit. - GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue �' - Glenwood Springs, Colorado 81601 , • INDIVIDUAL SEWAGE DISPOSAL PERMIT NS 376 Owner W. t. $ Mildred Booth System Location ' Poodle* Crook - 9 ratios SW of Grand Vallsq . Licensed Contractor j €t') /L/ G%72- Conditional Construction approval is hereby granted for a 756 gallon 0Y? /iVe' 1 4/n7) X Septic Tank or Aerated treatment Unit. Absorption area (or diapersal area) computed as follows: - Pere rate of one inch in c+C minutes requires a minimum of .^7'C.> sq. ft. of absorption area per bedroom. I Therefore the no. of bedrooms x 2 30 sq. ft. minimum requirement = a total of sq. ft. of absorption area. 1 1 May we suggest. ,/off- / X .-7©/ X 3 / 51.2-2. '--7 f" 4 672), Date / --- / 9' 77 Inspector -' "" / { 7 • ° I (INAL APPROVAL OF SYSTEM: t edi 5 No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to c vol.- ' ing any part. Cam- Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. ,1, - Ilt ^P�roopper materials and assembly. ��� v l rape name cEptic tank iii aerated treatment unit. q+ ®`r Adequate absorption (or dispersal) area. Adequate compliance with permit requirements compliance with County and t to regulations /requirements. n e0e a:Leer-ter _ Other 0• cS. - S , F7P- ' Caen cr"r "a&22 7. Date 6 t0 - - 27 Inspector _ / - -/ t RETAIN WITH RECEIPT RECORDS AT CONS RUCTI• t I Or *CONDITIONS: 1 - 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 1961 S' 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. bon of a requirement of the permit and cause for both legal action and revocation of the permit. 1 Section III, 124 requires any person who constructs, $Iters, 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 $ INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date- 14 -17 NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM Owner: . ,/�.44,7f.�J Mail Address: 4� � s) ,y, ,,� h 6, Ci ty: o « , Zip: AJo Phone: INFORMATION REGARD�ROJECT 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 47 ),1 City or Towng Legal Description `af JtyIn./ /C,ij 9Gk&O,n.Lot Size /f! g,,wilt 2. No. of Bedrooms Septic Tank Capacity /pan Aeration Unit Capacity 3. Source of Domestic Water: Public (name): p�!- Private: Well Depth Other ® Deah to first ground water table 4. Is facility within boundaries of a city /town or sanitation district? )20 . 5. Distance to nearest sewer system: , f 21 1_Y .. _ Q ��� * Have you attempted to arrange a connection wit system? y If rejected, what was the reason? 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=z= ,- 4 - /yy4 c 7. Name, address, and telephone of person who made soil absorption tests: S(-7 f :XD/II 0 8. Name, address, and telephone of person responsible for design of the system: (,Uf d0r, t — 42' - 4'-l/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. �j y 7 ate D / a /9l7 0I i4- Signaturre o Applicant (TO BE RETURNED TO HEALTH DEPT.) .s lob PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY - . I" is' i 1 ' . h ap 4 ki o9<c reto i d ,,,,, �-- .s \%, ere U INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- h BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES } A Do -te i r__1 -. � v . 4 (TO BE RETURNED TO HEALTH DEPT.)