HomeMy WebLinkAbout00534 * 1
This does not constitute
.. -� a building or use permit.
S ' GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue n
Glenwood Springs, Colorado 81601
Phone (303) 845 - 7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT Np 584
Owner Robert GOrdon
System Location Lot 8, Minnaota Satatea — 0234 Seneca Road
Licensed Contractor 'e c fJ iv r•-:- "C.--
Conditional Construction approval is hereby granted for a At to gallon
✓` Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in ,2 1) minutes requires a minimum of —7/ O sq. ft. of absorption area per bedroom.
. Therefore the no. of b�eeddir000..�msGs 9 x _ 7/€1 �/sq. ft. minimum requirement = a total of7rfO sq. ft. of absorption area.
May we suggest 4U U S 72. /� 70 rX 8 r7ee. -A- !'� -� � / l) c • i">
Date J . w+.a� e, /57f .Inspector ♦l e y".,C1 e0 - , ..IS...1
•
FINAL APPROVAL OF SYSTEM: �Y \ ;` ,u9v AA - I ,.
No system shall be deemed to be in compliance with e Sewage Qisposal Laws until the assembled system is approved prior to cover-
ing any part.
" - $eptic tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface. k , a ,.,..,
(' k Proper materials and assembly. tvcterq
CCir t r 4 + )tX rade name of septic tank or aerated treatment unit. ,a Ai
r t y �
C Adequate absorption (or dispersal) area. /ex 'V7 x 3 >, ' A/ 57 1( . C et /y-rd
,
OF- Adequate compliance with permit requirements. ,y- 64.
(` fr Adequate compliance with County and State regulatIons /requirements.,,,..
Other
Date S 715 Inspector /
nspector + =t / ,t, . (r /A/Pft- tc)/i /e
RETAIN WITH RECEIPT RECORDSATCONSTRUCTI6N I cf�a CC /�.ca4«
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pyrsuant 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, orinstalls 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 r �
r/ NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE r _
/
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: j T ( 14-, •
Mail Address: ," Z7 City: CV/ Zip: era Phone: $�,�,c
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 facilit County i City or Town c:f
e /n4 44i r{tio
Legal Description 473 1c Sepeai C Lot Size /Ls/ ,a
2. No. of Bedrooms ¢ Septic Tank Capacity ,,4 <-o Aeration Unit Capacity
3. Source of Domestic Water: 'ub • (name): �4 ;t4t4 4a 4 4 4,s
Private: Well al Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? co
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system? ,L C.)
If rejected, what was the reason? JC,�
6. Rate of absorption in test holes shown on the location map, in mi tes per inch of .
drop in water level after holes have been soaked for 24 hours:.
7. Name, address, and telephone of person who made soil absorption sts:
8. Name, address, and telephone of person responsible for design he system:
r te! '
9. Express permission is hereby granted for the inspection f 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
includVV- d therein. • _. % !
Date Si.nature o Applican
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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pit A/ivu/ 0/7—
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/it INDICATE BELOW THE LOCATION OF YOUR BUILDINGS Wl ER SUP'LY AND DISTRI—
I :U 11 1E , . - 4V , P. 11 D ,. . , . , .1 :,I!, ' 1
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Ite- sew
-_ 4/ (TO BE RETURNED TO HEALTH DEPT.)