HomeMy WebLinkAbout00495 This does not constitute
' , a building or use permit.
Y
v GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
i . 4 ,.2014 Blake Avenue
Glei$vo d Springs, Colorado 81601
iii
INDIVIDUAL SEWAGE DISPOSAL PERMIT ' , 5
n; -
Owner John H. Arthur
System Location South of Silt ' . ` '
Licensed Contractor _ L _'GL .k . - .1: iv L:' : , ..1r*3 tO
* Conditional Construction approval is hereby granted fora One gallon
X Septic Tank or Aerated treatment "unit.
Absorption area (or diapers& area) computed as follows: P
Perc rate of one inch in .. minutes requires a minimum of 301=7 sq. ft. of absorption area per bedroom.
" 'afore the,no.of bedrooms. el x . sq, ft. minimum requirement = a total of 9sq. ft. of absorption area.
` ., •, t.
;v 0ateWe r
/ / ." �SCi0 �'°��'s�' �� � / l r X *,.
„..
„.
,
FINA .. R 6 ' •K ' ' ‘ . '' 0
Inspector
w
APPROV'AL0F SY, /1`EM: —.
No,aystem shall be tleertied to be in compliance with the swage Disposal Laws until the assembled system is approved prior ib cover”
Iii ing any, part.
:k j, —/�' Septic Tank clean,out to within 12" of final grade or aerdled acoessports above grade. -
t .
a .e�.�i 4
t ° ^ ' CPC Proper.materials and assembly. r 5
__f _____ /Jtilr //a., i na o c ....
T$ f'sepUC tank or aerated t'raatglQnt unit.. +
I. . " .,r. i
t i ~ :• '41 q
r ,,, 1 A`dgquate absorption (or dispersal) area e3Z, • /.k 4 X (•s ereieW1/2616-4 E 1/2616-4 } , r
Adequate compliance with pefrttit requirements.. , h , y
'/
t;: , 9 ./ Adequate compliance withCoun'tyand State regulations /requirements.
r t'. O r � - y
.Ddte � + ,, G , Inspector "/ t
s r,• V`, RETAIN WITH RECEIPT., CORDS AT CONST kUCTION SITE
t ht., f
*CONDITION 1.. t
• 1. All instaliatigt n lrl tt c with all requirements of the,County Individdal Sewage Dispo §al Regulations aG opted pursuant to au -;I
thority granted In CHS;f963, amended 66 -3.1 , CRS 1963."^ ,,
2. This permit is valid only for ^connection to structures Which have dully ddmplied with County Zoning and, building"requiremer
Connection td'or use with Any dwelliggor structures h t approved by the building and Zoning office shall automatically be a villa-
tion of a requirement gf the pdrmit an Cause for both legal action - and revocation of the permit. l ik , " f
't 3. Section ill, 3.244requlfes,ianyperson who constructs, alters, or installs art indivi jual sewage disposal system in a ma her which in
valves a knowinthqild material variation from the - terms or speciticatlbns contained in the application of permit colt :nits a Class!,
rti Petty Offense ($5ot 00 fine; -8 months in jail or both. a, '
II Building o fficial -' Pe White Copy r f4Appligant - Green Copy Dept, -.Pink Copy
a.
Fees Paid 57SI
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date 1 I -a ?7
/ /AN!? •
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
/ INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: yr-1.,2 � , �!r • Qate„)
Mail Address: /S/3 / ltd o City: 7i.1 &_. k e, Zip: 2/0[7 _ Phone: f7 _ ? 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 y L', ,.
„[� City or Town 4. o�.,�;
f vo c '+be. NE4 6104 See. 13 T S Q a U) Legal Legal Descr G4at;tl. Gn,,
,,, tY Lot Size /� r ff e S
2. No. of Bedrooms -3 Septic Tank Capacity loco Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well Depth 4100 ' Other Depth to first ground water table el
4. Is facility within boundaries of a city /town or sanitation district? yu,
5. Distance to nearest sewer system: /0 t1 .tts
Have you attempted to arrange a connection with the system? 'p ,
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:
7. Name, address, and telephone of person who made soi' absorption tests:\
PV / &
addres , a��lephone of person rp ''ns'b e�fo ign of the system.
' tt t/ ' /Y _ � a Alas t& 2"7 - ?/ S 'a
•
_ -- - •.c_ L In ice!
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.
//1
C . Date ignat� of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
: • PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
7ffir . x
o
w u cr
S
•
•
ri
_ Cc Rsxi0. -ka
1 s (
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
DIMON LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
4;__f;3°Q9 _ 320.:' .
\ -t-N, 1'
T
w 0
� V 1, 1 ,I,� .
c
\' >3 'a
V �‘. ` \` \ 9
%IS, W
0 .4 1
.%' I .�
Fc> v
fl .:"
-t k \
ti
\---‘ ct k g
'tit v 1 \
A 1
_ _ . S g 73
(TO BE RETURNED TO HEALTH DEPT.)
