HomeMy WebLinkAbout00465 This does not constitute
'I �r LTEf' -0E' #9 7 ON f a building or use permit.
I I .to GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
,?r 2014 Blake Avenue
Glenwood Springs, Colorado 81601
,I
E Z C., O(u Y
INDIVIDUAL SEWAGE DISPOSAL PERMIT NV1 465
Owner ye:lE e/4. 4 h/ 1A/.."... 5 0 A/
System Locat 62.574
. .S /U 9 ,� Ci9,." `ego . vea -L ''" C/o .
Licensed Contractor 0C4/ /t /t / '
oil ,/
iiii ii: " Conditional Construction approval is hereby granted for a 7..5` ?? gallon
V Septic Tank or Aerated treatmentpinit.
Absorptiop or diapersal area) computed as follows:
Perc rate of one inch in / , minutes requires a minimum of 0 /GS ` sq. ft. of absorption area per bedroom.
Therefore the no of bedrooms x /65 sq. ft minimum requirement = a total of J j? 0 sq. ft. of absorption area
_
May we suggest /es>'.1'..2 -� /i .3 / ..3 t 'n'c- •c e `�
� � /�
Date c- ` ..7" Inspector > r �,j / '-�
FINAL APPROVAL OF SYSTEM: i If . 1411 I* t�Q /
�
No system shall be deemed to be in compliance with the SewaY Disposal Laws until the assembled system is approved prior to cover
ing any part.
yp '--- ' Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
.. Proper materials and assembly.
I e,.i /� Trade na - . . _ .orated treatment unit.
1 /-- Adequate absorption (or dispersal) area,
..____s — Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Other e
G1 e
1, Date v re"' 2 7 Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS:
1.1All 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 requirementf >
Connection to or use with any dwelling or structures not approved by the building and Zoning office shall automatically be a viola. q1 1 , `
tion of a requirement of the permit and cause for both legal action and revocation of the permit. il'J
3. Section III, 3.24 requires any person who constructsdalters, or installs an individual sewage disposal system in a manner which in. .11j
volves a knowing and material variation from the tenth or specifications contained in the application of permit commits a Class ly h 11
dpi Petty Offense ($500.00 fine - 6 months in jail or both. w„ ii, ,1 11
1 I q m,
Building Official — Permit White Copy Applicant --1. Green Copy Dept. — Pink Copy
Fees Paid $ ___
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION Date
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: L3 d'41 / A H w[ I Soli
Mail Address: 6111 ito7 'fib City: CA A040. Zip:gti. Phone:73-'
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 C4CFMeta �� City or Town Caee0N0418
Legal Description ir R.e /teeIf � r 1 c,rrl of Size 4 pSy S FT
2. No. of Bedrooms 2. Septic Tank Capacity 7S—C) Aeration Unit Capacity
3. Source of Domestic Water: Public (name): Wa
Private: Well I/ Depth y 3 Other Depth to first ground water table 17
4. Is facility within boundaries of a city /town or sanitation district? A/p
5. Distance to nearest sewer system: ,95
Have you attempted to arrange a connection with the system? go
If rejected, what was the reason?
(,b. 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: � �D,yyt /
-1. Name, address, and telephone of person who made soil absorption tests:
yetr /(6-7141414
04. Name, address, and telephone of person responsible for design of the system:
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.
v3 — 7 7 ,�✓ ����
Date �- S at e of Appl ant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
.
•
G � S
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.)