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HomeMy WebLinkAbout00458 N.27- - o o .. .. t This does not constitute r r , ,; _ a building or use p ermit. il GARFIELD COUNTY DEPARtMENT OF ENVIRONMENTAL HEALTH r 2014 , Blake Avenue Glenwood S Srings, Colorado 81601 f ul �T p - INDIVIDUAL SEWAGE DISPOSAL PERMIT N5';. 4 III i t Owner Chuck asoksr System Location Lot 25, Asgard Subdivision - , I 3rd Filing 1 9 l 7 �A , Licensed Contractor OW A/ e, • Conditional Construction approval is hereby granted for _ t '- t gallon X Septic Tank or Aerated treatment Unit. 1 Absorption area (or diapersal area) computed as follows: Perc rate of one inch in °,1 minutes requires a minimum of ,30C) sq. ft. of absorption area per bedroom. Therefore the no of bedrooms x - 3C-CJsq. ft minimum requirement = a total of sq. ft. of absorption area r _5 / c ., May we suggest � 02 ,.t' �• ,.+' / /� i • Date , '� ' 7,, V Insp ector'' - �l i a ' i' , (.� FINAL APPROVAL OF SYSTEM: • 4Pss . ) 4 No system shall be deemed to be in compliance with the •wage Disposal Laws until the assembled system is approved prior to cover- ing any part. - nrrna Tank cleanout to within 12" of final grade or aerated access ports above grade .© - n U Proper materials and assembly, ca ---f- n Trade name of septic tank or aerated treatment unit. c I I . ea'7G- Adequate absorption (or dispersal) area ��.. Z. — 77 iP O - nge compliance with permit requirements. 0,G%- r r % Adequate compliance with County and State regulations /requirements - G�-C— HI Other Date 3 a- p ' cr-3 Inspector < 14--; RETAIN 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 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 viola- tion 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- iii II14 volves a knowing and material variation from the term$ or specifications contained in the application of permit commits a Class 1, Ii Petty Offense ($500.00 fine — 6 months in jail or both i I { i II (In(1 ri } i1;A ! I 41 11 , i '� . 1 1 W �' y M,�', �^' f ( p i i i ' I i r] I il i ll V °;1111 111_ 8 Ri r I � x ri 1y -11 igg�_ Xi I I I 1 e lII mi WW li YI P 4I I tllII v n I r { IF 4j. I ��1 .0 1 1 4 1 1 1 9 1 s u ' __ VVI �dI IWI . ,t41! __ I _ � I II I 6 °6' ��a IPILa Fees Paid CS INDIVIDUAL SEWAGE DISPOSAL.SYSTEMS APPLICATION Date q Or NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM Owner: ()L, 1 A r-4 Mail Address:O fti� _ 2/ 4 -,a1 City: / .,j� Zip:g /45D Phone: .7 , 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 ity or Town C Ar 3 Legal Description g „ , _ d 1 _r 4.' Lot Size /Q ctt, 2. No. of Bedrooms „,L Septic Tank Capacity 7j Aeration Unit Capacity 3. Source of Domestic Water: Public (name): /,_ /I. i ley , ,,- c I_ e ' Private: Well X Depthl229 Other Depth to first ground water table 4. Is facility within boundaries of a city /town or sanitation district? ///e; 5. Distance to nearest sewer system: _21 2 d eli,L , Have you attempted to arrange a connection with the system? 44; If rejected, what was the reason? 6. Rate of absorption in test holes shown on the location map, in mina / per inch of -- (0 drop in water level after holes have been soaked for 24 hours: A , , id i ii 7. Name, address, and telephone of person who made soil absorption tes M -i-VeA/Lar.S 8. Name, address, and telephone of person responsible for design o th system &G .o.��� 9. Express permission is hereby granted for the inspection of t e above roperty 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. 9 /' 7 7 /% � 41, to Signatu'- s Applicant (TO BE RETURNED TO HEALTH DEPT.) • GARFIE'LD: COUNTY DEPARTMENT OF. DEVELOPMENT PLANNING: 945 -8212 / ENVIRONMENTAL HEALTH: 945 -2339 / BUILDING: 945 -8241 AFFIDAVIT I, et ' _ ' I .4-t t/ i DO HEREBY SWEAR THE FOLLOWING INFORMATIO TO BE TRUE AND CORRECT IN.REGARD TO THE INDIVIDUAL SEWAGE DISPOSAL SYSTEM WHICH I WAS RESPONSIBLE FOR THE INSTALLATION THEREOF ON THE PROPERTY OWNED BY Gary M. and Nancy J. Ullinskey • Lot 25, Asgard Subdivision, Filing No. 3 SEPTIC TANK SIZE 14()419 Jt d ���- SEPTIC TANK TRADE NAME, a./ 11 !4� C{D�`�_ LENGTH OF SEEPAGE BED 5'G WIDTH OF SEEPAGE BED f.2 (- DEPTH OF SEEPAGE BED 3' DISTANCE OF SEEPAGE BED TO WELL k Gvi ii , DISTANCE OF SEEPAGE BED TO RIVER Q '/0 /y w�c,c i • SIGNED: 4) ,, L. _,/ . -D; _ 'C_..2 DATE: % . !o . 7. 7 , 3 . • 2014 BLAKE AVENUE GLENWOOD SPRINGS. COLORADO 81601 •