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Home My WebLink About00549 • This does not constitute a building or use permit. • GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 RERAIR — MSC ONLY Phone (303) 945-7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT we 549 Owner Kenneth R, Pidgeon System Location Glen / wQod�nga Licensed Contractor * Conditional Construction approval is hereby granted for a / C gallon Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: / Perc rate of one inch in / 140 minutes requires a minimum of ��O sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x /`'sq.. ft, o g? minimum �Er ` requirement = a total of .0 q. ft. of absorption area. & May we suggest �ll��/. e e c..7 0 ,/� , / X O e - e-- , ,(��j � � s.7 Date 722 V „� { • � , 7 i., (1 r.10 •1nsa r „'6 �l? 2 . L e°r I t � e FINAL APPROVAL F ,pY 7 M: 4 IN { t t -- -4 ce 7 /4'z) ''v " d �� VY IY - c No systpm shall be dfle� �ed to i 'ance ith �a �� / Dispdfi1L ws dntilth 'aslemble system is approved cover- prior to InganyPparP.d »'- 1..� T +..I bl'.>i v'l9e r - .: ^ :. JJ // ro n.c� -; ct On 7 h, iw��v.. —. iCJ7:,1 '-8eptie ankticbe5#4 or tnsp uon and cleaning within 12" of ground surface or aer ted access ports aboy6'grbund sujfa 7 " r t . re 10 e a.! Q r k Pf Op ey :rnaterials 5nh -asembhv., rx ✓IO'a '1 Q ., / a t , r "7.(t'f)(r 1♦ • > ,� '1 \ y �7:- -..� -4 1 > "' ! d � �� t�' raQa�of�alTtict $11k% a�ratedttfe>Ctr t (eh�unif. ' /f,f � 4' Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. / Other �J '�' ! / Date ) ' 7 Cs Inspector �- �9 / r /< 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 III, 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 1, 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 KOV INDIVIDUAL SEWAGE DISPOSAL: SYSTEMS APPLICATION Date 5 NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE' INDIVIDUAL HOME SEWAGE TREATMENT. SYSTEM d�ti� Owner: ' 14WA.erN ?. ? ;d � I'ofl Mail Address: t 00.,2d //0 City Q /.,cutup s4sZip: silo t Phone: 95 - 7j 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 Garfield City or Town (; /4,,rku se/d Legal Description k IZ vVL Lot Size /, q f1 cti<f 2. No. of Bedrooms 1/ Septic Tank Capacity Aeration Unit Capacity 3. Source of Domestic Water: Public (name): C,177.(( Cg<<K tNAr„k //floc. Private: Well Depth Other Depth to first ground water table(.u3 4. Is facility within boundaries of a city /town or sanitation district? 5. Distance to nearest sewer system: Have you attempted to arrange a connection with the system? If rejected, what was the reason? 6. Rate of absorption in test holes shown on the location map, in mi lutes •er inch of / drop in water level after holes have been soaked for 24 hours: !� / 'y 7. Name, address, and telephone of person who made soil absorption tests Q.t 8. Name, address, and telephone of person responsible for design of e stem: ' 9. Express permission is hereby granted for the inspection of the above p •perty 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. • f , , 7 �VIGb< 11 � i D ate Signature of Appldjant (TO BE RETURNED TO HEALTH DEPT.) WIMPPIr PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY V r /` n /10 ro, I/o INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES o i rcz fist n- cu --- / (TO BE RETURNED TO HEALTH DEPT.)