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This does not constitute
a building or use permit,
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
ALTERATION - FEE WAIVED) - PERC ONL9lenwood Springs, Colorado 81601
INDIVIDUAL SEWAGE DISPOSAL PERMIT NVi 400
Owner Mary 0, Christensen
System Location 4779 County Road 117 - G1 ehwood Springs
Licensed Contractor Hari ey Ri ppy
* Conditional Construction approval is hereby granted for a f _L2QL2 gallon
x Septibtiank or Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in 3d minutes requires a minimum of a 7? sq. ft. of absorption area per bedroom.
Therefore the'no- of bedrooms +3 x ,aSZ:tq- ft, minimum requirement = a total of ,Z5Zaq- ft, of absorption area
1 . May we suggest . / ,X 6. .3 1.1 i1'' .� / 5 E= =•:: "•2� /Sr7r. C .<F:' "�,
Date � " 7- 7 7 Inspector < >�r r! r F s'
FINAL APPROVAL OF SYSTEM: ' 'Yw W
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to coye`^
ing any part.
S(% Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
0 �� yy 6 Trade name of Sr aerated treatment unit-
ners Adequate absorption (or dispersal) area,.
• � -- Adequate compliance with permit requirements.
v/C Adequate compliance with County and State regulations /requirements.
Other -
Date 79 7 Inspector - -
HET ' -1 WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1- All installation must comp) i "r ' all requirements of the County Individute Sewage Disposal Regulations, adopted pursuant to no
thority granted in 66.44 -4, CRS 1963, amended 66 -3 -14, OR$'!963-
2- This permit is valid only for connection to structures pvhu4i 4iave fully complied with County Zoning and building requirements.
Connection to or use with any dwelling or structures tot proved by the building and Zoning office shall automatically be a viola
Lion of a requirement of the permit and cause for both;legisl action and revocation of the permit.
3. Section III, 124 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which 1
volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class
Petty Offense ($500.00 fine - 6 months in jail or both,
Building Official - Permit White Copy Applicant - Green Copy Dept. - Pink Copy
Fees Paid $9
INDIVIDUAL SEWAGE DISPOSAL.SYSTEMS APPLICATION Date Sr S > 77
• O NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: fin D Ci//T/ c repos/ diry
Mail Address: 4 C,C A City: Phone (
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 0��(,.4 City or Town
Legal Description if -7 // Lot Size 20 dc/tei
2. No. of Bedrooms . 3 Septic Tank Capacity Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well 9r4 Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? A4
5. Distance to nearest sewer system: 440-7/!e �0
Have you attempted to arrange a connection with the system? Iv GE.
If rejected, what was the reason? ,7 7.ny ->Ye-er
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: fan? /
7. Name, address, and telephone of person who made soil absorption tests:
Sea
8. Name, address, and telephone of person responsible for design of the system: C
•
136 7 1
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.
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.
( 7/7 e /7 7 7 _tags/ .
is gnature of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
20 ac rc s _� Z
•
SP
Q o
uc e
( ,/
tz)
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
$UIION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE RETURNED TO HEALTH DEPT.)