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Home My WebLink About00614 M This does not constitute a building or use permit. rig GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (303) 945-7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT N:' 614 / l Owner Dot /9 aR Staniar* (Vnntar1 A u i 1Qnj^a (Ytt� 11' orto2) _ - System Location R1 fig — . ‘Zt 12 L. T "<' • -210 Licensed Contractor " Conditional Construction approval is hereby granted for a 1 n00 gallon X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in .-, 0 minutes requires a minimum of ri✓ /l) sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms t x ..? it sq. ft, minimum requirement = a total of ( n sq. ft. of absorption area. May we suggest /,�_ / „r s'," /X 3 'SEtratne c-.c 44 7 Date ` k. / f � � — ."— J S -, Inspector _ 7 ° `�/ FINAL APPROVAL OF SYSTEM: v r No system shall be deemed to be in compliance with the Seyiage Disposal Laws until We assembled system is approved pri61`H0.85nu rs ing any part. (1_ Septic Tank access for inspection Ind cleaning within 12" of ground surface or aerated access ports above ground surface - a Proper materials and assembly. a geeethraade name of septic tank or aerated tre'itment unit. Adequate absorption (or dispersal) area: - y1 :.7: - Adequate compliance with permit requiFments, • :. Adequate compliance with County and'$jafe regulations /requirements. Other - Date /7 — e-� - K — 7�' 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 pursuant to au- thority granted in 66-44-4, QRS 1963, amended 66 -3 -14, CRS 1963. 2. This permit is valid only fot connectio to structures which have fully complied with County zoning and building. requirements. Connection to or use with Any dwellintor structures not approved by the Building and Zoning office shall automatically bee viola- tion of a requirement of thl'permit an cause for bottfpgal action and revocation of the permit 1 Section .III, 3:24 requires any.persdn o constructs; filters, or installs an individual sewage disposal system in a manner which in -1. ,, volves 8 knowing 6n8 material: variation -from the teims or specifications contained in the application of permit commits a Class 1, • Petty Offense ($500.00 fine — 6 monthriti jail or both). Buildinll Official Permit White Copy Applicant — Green Copy Dept. — Pink Copy CASA Fees Paid $ f Sw INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE 1 / INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ThnnaLS/„_ V9y .^ .C3xaFw... Owner: D (4 6 S S ke % G a - Mail Address: 92Pyf K,/7 Z-/O City: /c i/G Zip: 8 /(,,S a Phone: 276 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 .�i / /Y E /y 56 '/ti 5 c %y p¢ Ce / Vd roccitifL 6 So Legal Description *e43wy , P/g t4,4 Sto Size /0 /Q -c ,eC fry c,/ -sia "� S l r-i li)er.,O' c'4ei.,(,Q L 2. No. of Bedrooms 3 Septic Tank C pacit y /06o ,g,e ration Unit Capacity ion 3. Source of Domestic Water: Public (name): Private: Well Depth Other / Depth to first ground water table/Oo 4. Is facility within boundaries of a city /town or sanitation district? /!/o 5. Distance to nearest sewer system: / /77 /c E 1 Have you attempted to arrange a connection with the system? t /7/! If rejected, what was the reason? ova 6. Rate of absorption in test holes shown on the location map, in minute's per inch of drop in water level after holes have been soaked for 24 hours: , c e f r 7. Name, address, and telephone of person who made soil absorption tests: 8. Name, address, and telephone of person responsible for design of the system: 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. 4(iS i`c L L$ Date Signature of Applicant (TO BE RETURNED TO HEALTH DEPT.) CViimuen-•;• .tJ� PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY dJ • idc . ■_____ ,. a -,-- - 1, 1 -c ic, it INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES i j f 7 - i 1 \...- ' (TO BE RETURNED TO HEALTH DEPT.)