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This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945-7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT T2 550
Owner Rollin L. Estee
System Location Rifle
Licensed Contractor Owner
* Conditional Construction approval is hereby granted for a 1,000 gallon
X Septic Tank or Aerated treatment unit.
BEE PERMIT 11443 FOR PERC
Absorption area (or dispersal area) computed as follows: also, see below .• —,�
Perc rate of one inch in 5 minutes requires a minimum of 125 _sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms — x 725 sq. ft. minimum requirement = a total of . 374 sq. ft. of absorption area.
May we suggest peep ,field 10' x 20' x 10' and 8' deep below leach line.
(if ge•pagi bad, a ratpim of 12' x 63' r ' quire based on pert rate of
Date 0 n, / Inch - 5 -9 -78 b y R, W.) Inspector S— I I -I y
FINALAPPROVAL OF SYSTEM: f e 4-6_0-6
No system shall be deemed to be in compliance 10 h the Sewage Disposal Laws until the assembled system is approved prior to cover-
' ing any part.
P.1" Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
_ ) Proper materials and assembly.
/ Trade name of septic tank or aerated treatment unit.
Adequate absorption (or dispersal) area.
(it" Adequate compliance with permit requirements.
Oge Adequate compliance with County and State regulations /requirements.
.Other
<
Date c " .�- - 1/ A �� p Inspector // •
.
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
"CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted purs ent 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 whirr'
volves a knowing and material variation from the terms or specifications contained in the application of permit commit9 7
Petty Offense ($500.00 fine — 6 months in jail or both).
Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy 7
,,
_
Fees Paid $"7<r
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date S
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT,SYSTEM
Owner: i {l L. �G S
Mail Address: px /3 3 1 City: P fc? Zip: ? /o,V 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 facility: County Garfield City or Town 7I
5E lq �s6va,sw
evst �o
Legal Description T.&S.,R,g3W i4j �Size /e) p 1%Pit.11
2. No. of Bedrooms ,3 Septic U Tank Capacity � / Aeration Unit Capacity
3. Source of Domestic Water: Public (name): I_, 1 IZ J , � li
Private: Well Depth Other Depi to first ground water table
4. Is facility within boundaries of a city/town or sanitation district?
5. Distance to nearest sewer system: Yta
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 mintftes p-r inch of k
drop in water level after holes have been soaked for 24 hours:
7. Name, address, and telephone of person who made soil absorption tests:
A( i
4. '
3. Name, address, and telephone of person responsible for design of e system:
Express permission is hereby granted for the inspection of t e above o�erty 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.
I. 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.
r �+
/i /Date / Signature f Applicant
(TO BE RETURNED TO HEALTH DEPT.)
= L
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY /
so
_a l e
0
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE RETURNED TO HEALTH DEPT.)