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This does not constitute,
,1µ a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
REMIT & ALTERATION - PERC ONLY
INDIVIDUAL SEWAGE DISPOSAL PERMIT Nei 479
Owner
willlam F Constance Garlltt t'r
System Location 6023 County Road 210 - New Castle
Licensed Contractor
Conditional Construction approval is hereby granted for a 4.Gt c, gallon
X Septic Tank or Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in k minutes requires a minimum of /J C sq. ft. of absorption area per bedroom.
Therefore the no of bedrooms ✓° x ft. minimum requirement = a total of _ 4sq. ft. of absorption area
May we suggest L„.?RY 0 E= l_. t /0 / .SG C.I /9 I4' y / � [� C -" ,(y -7 , c � C? 0cU /N /e:=
Date
°N l� / 7 Inspector
C, 79r c cez, .s /Z/ .v G /� X3�'x 3
FINAL APPROVAL OF SYSTEM: o " , op • _J
No system shall be deemed to be in compliance wi the Sewage Disposal Laws until the assembled system is approved prior to cover-
.
ing any part.
1 Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
�� i Proper materials and assembly,
It--gi/4t_ '1 ATrade name of eptic tank r aerated treatment unit.
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Adequate absorption (or dispersal) area. „2 / e 33 / X 3 'S' e77,--7°79-c, e ����
P P
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xs t, Adequate compliance with permit requirements.
Se Adequate compliance with County and State regulations /requirements.
// Other /
// S /
Date - 4 7 , Inspector — s '
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 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 $_S
INDIVIDUAL SEWAGE DISPOSAL.SYSTEMS APPLICATION Date 10
. NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE ViiTAIQ ALT, _
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Ps(7—c, ow -y
Owner: llthaKcror) (/ 5-n-a -ems 4.,. _
Mail Address: , z-t'.3 A? ;2"/ City: e ZiP: r/s v7 Phone: _--ad
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 s , , City or Town Yj �,,7/
3W,4 NE4 of Ca T/, 6 /o} / a NdwiP(.
Legal Description.foarw ajrofrxe6PpI,NO,s &Lot SC*r 49 ()Fat ACRE
2. No. of Bedrooms ,.5 Septic Tank Capacity k / ��
Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well )( Depth ,t7O / Other Depth to first ground water table 1-
4. Is facility within boundaries of a city /town or sanitation district? 7 o
5. Distance to nearest sewer system: _2t, '
Have you attempted to arrange a connection with the system? ;vie)
If rejected, what was the reason? i
6. Rate of absorption in test holes shown on the location map, in min tes p =r inch of
drop in water level after holes have been soaked for 24 hours: /_y, ,1, /i
7. Name, address, and telephone of person who made soil absorption t sts:
8. Name, address, and telephone of person responsible for design of A system:
Qh . J - -- _ . T --
9. Express permission is hereby granted for the inspection of the above operty 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.
/6/6/77
Date Signature u e of Applican
(TO BE RETURNED TO HEALTH DEPT.)
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A tract of land, located in the SWINE* of Section 5, Township 6 South, Range
91 West of the 6th Principal Meridian described as follows:
Beginning at a point on the Northerly boundary of the County road, whence the
East Quarter Corner of said Section 5 bears S. 68 °55' E. 2490.90 feet;
thence along the County road Northerly boundary S. 69 °58' W. 48.00 feet;
thence along said County road boundary S. 65 °21' W. 84.00 feet;
thence along said County road boundary S. 63 °40' W. 17.00 feet;
thence N. 20'39! W. 128.52 feet;
thence N. 54 °43' 35" E. 222.95 feet to the Westerly boundary of that tract of
land described in Document No. 205513 of the Garfield County records;
thence along said Westerly boundary, South 100.00 feet to the point of beginning.
Together with all water and water rights, ditches and ditch rights appurtenant
thereto or used theron including specifically one- half(-2)share in the Roseman
Ditch Company and the water and ditch rights represented thereby.
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PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BU(ION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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(TO BE RETURNED TO HEALTH DEPT.)