HomeMy WebLinkAbout00506 --- I`s^'• - . , .. _ _. - .. ______ _
4,
,. This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2 2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945 -7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT /4;4...) 59
Owner - .[- '' . .i,>tr •'C� I' Jc(/ ...7 r':i,
....
System Location + 0f//Ll0 4° _ / r " yf, 4. ..04, S /edd/� /(/fl- % `-CJA ) _r
Licensed Contractor ,: '. ,r r ,. . i . ^ ,._ ., c ," -r / . .. i' -• +l IC..
' Conditional Construction approval is hereby granted for a _.C`,' L''C C. gallon ,
' Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows: ,
1
Pere rate of one inch ins,? c"' minutes requires a minimum of e.1 "?c' +sq. ft. of absorption area per bedroom. '
Therefore the no of bedrooms, -_ oft x°':^ . " sq. ft. minimum requirement= a total Of sq. ft..of absorption area.
May we suggest l'J `,
"
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Date , / ./,,,�.. ,:.. Inspector -
ff O � i ,
FINAL APPROVAL OF SYSTEM: ` i �.) '
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No system shall be deemed to be ih complianctwith the Sewage Disposal Laws until the assembled system is approved prior to cover-
" ing any part. r .%
% i ..
Septic Tank adces {�fiot Inspection and cleaning within 12" of ground surface;or aerated access ports above ground
surface. k ^t "� � ��f4- Z
Proper a ° teriatss an assembly. • -, a t
1 („ na • a s e ptic t ank or aerated tr unit ,'
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r., e C m Adg r at
ege urptign (or disper ;a0 area ..1 + . '4r
A � . � A�lelluate compliance with permit requirements. y ' oh.
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..�Ora tlgquate'Lb` lianEE and to r 'IT twns /regtiTici i`etic. Si
S - : . - .
' 1 4, Other ,, C" freer* .d ' e „ - ∎ e Y
D'@te h A+ " ft5, '�' ` 7 + Inspector " ' - { 'p. 4� I
C. : �R fAI, WITH .RECEIPT RECORDS tTGONSTR',UCTIO�V .
c. . .
`CONDITIONS 4b : s x . i 1 x ,, ; °'fit w .•, r
All install -von t%lust W1 P1(' requi o the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thoritygragjpdul +.4 RS11 amended 66:3 -14,C 190.
•"2 This permit•is valid oriffPfifit.c on'td st uctu es which have fully complied with County zoning and building requirements.
cofnmectiofi /o 6r use with an{ or structures not approved by the Bpjtding and Zoning office shall automatically be a viola.
} Sion of a requirement.of khe: permit and cause for both legal action and revocation of the permit.
t t , -: 3 - Section III„ 3.24. ret1uiotinjy,,gq sq$.- *ho constructs, alters,.or installs an individual sewage disposal system in a manner which in
. ery " vplves a,kpowin and material variation from the terms or specifications - contained in the application of permit commits a Class I,
PettV' (550.90 floe — 6 months in jail orboth).
Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
Fees Paid $7s, °-°
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION
0 - '' Date a 1
4 NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME. SEWAGE TREATMENT SYSTEM
Owner: — h40 . r on/�. j4f 2 ._ .
Mail Address: 0 s. orfl0� City: . : o✓j G ip: 6/k/ Phone:S —Z
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 49iefjrc/> City or Town ,SILK'
Legal Description7,�p ,r, t iff25i -- /q7 73 Lot Size $ 4c,
2. No. of Bedrooms / Septic Tank Capacity Aeration U it Capacity
3. Source of Domestic Water: Public (name): pbt4tihiA4_ 9 / apcowrt/-Cw
Private: Well ✓ Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /C/o
5. Distance to nearest sewer system: .526 1 - I nn e-_ -/'
Have you attempted to arrange a connection with the system? /V. 4.
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in mint s • inch of YJ
•
drop in water level after holes have been soaked for 24 hours: ,I 'AAA A
7. Name, address, and telephone of person who made soil absorpii n st /��
OG
8. Name, address, and telephone of person responsible for der'. th system:
9. Express permission is hereby granted for the inspection o the abo 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.
t /`I /3 , �
/Date ` a
Si g na ture of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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Okeran-
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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-\- 1 IZ r 2 ( 4. ih en_)
\______ ---„________ _
(TO BE RETURNED TO HEALTH DEPT.) ■
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