HomeMy WebLinkAbout00728 , t
“r" ♦ „ - -�� This does not constitute
. � , a building or use permit. ,
.. + GARFIELD COUN DEPARTMENT OF ENVIRONMENTAL HEALTH
LTERATION 2014 Blake Avenue
Glenwood Springs, Colorado 81601
-R. R.P. E. PERC - Phone (303) 945 -7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT NTIA • 728
NO CHARGE
Owner R1fle .Fireside_ M II
System Location North Of Rifle i -
Licensed Contractor Bob 'Risley
S e -
Conditional Construction approval is hereby granted for p ans ' gallon
see
plans Septic Tank or Aerated treatment unit. ^'
Absorption area (or dispersal area) computed as follows: �
• see see
Perc rate of one inch in Plans minutes requires a minimum of plans Sq. ft. of absorption area per bedroom.
See see ,see
Therefore the no. of bedrooms pl ans x plans sq. ft. minimum requirement = a total of p ans sq. ft. of absorption area.
May wesuggest Plans & s e s, of recmmended R.P,E,. approved - see p ans attached (Board f Health
,° reviewed 6 -18 -79 and recommended approval
Date .. JUg” 1R.,f1979 Inspector
-. ,
FINAL APPROVAL OF SYSTEM:„ •'..
No system shalebe deemed to be in compliance writ the Sewage Disposal Laws until the assembled system is approved prior to cover-
inganypart.' "'''-
Sipgc Tanleaccess for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
Proper materials and assembly.
Trade of septic tank or aerated treatment unit. ."
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
I Adequate compliance with County and State regulations /requirements.
Other
Date 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, 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 111, 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
ALT E:I(AIICU & I <LP11IR - R.P,E PLRC - NU CHAR
GL permit isTU 728
CHARGES Name of Applicant Rifle Fireside II
Percolation Test $50.00 Amount Paid No Charge
(includes final inspection)
Permit Processing Fee $25.00
Date FtbYcK June 18, 1979
i Check (nVoVRI Cashier TLS
Cash No Charge
Money Order
ALL CHECKS ARE TO BE MADE PAYABLE TO GARFIELD COUNTY CLERK AND RECORDER.
Clerk & Recorder — Receipt White Copy Applicant — Green Copy Dept. — Pink Copy
NO
`,, Fees Paid $,cE
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION
Date /0 -/8
l NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE /en 7F4=c-
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM , It - r , 9 - 7 - , e,
rr Za
Owner: /tc c= /� //7-e //J r= __Tr
6,21
Mail Address: Dr'7 fore-/, ';3r � cCity: $', p /b- Zip: ? /63 Phone: 2233
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 A c>/ /L//% c
Legal Description ;�'(—� e _ -- Lot Size /z c= 7 2
2. No. of Bedrooms - 1 Tank Capacity /1 St ' 4.1 Aer tion Unit Capacity
3. Source of Domestic Water: Public (name): '
Private: Well X Depth Other Depth to first ground water g table f '
NO
4. Is facility within boundaries of a city /town or sanitation district? Iv O
5. Distance to nearest sewer system: -f fr ,L F r
Have you attempted to arrange a connection with the system? NO
O
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes per inch of
drop in water level after holes have been soaked for 24 hours: / " l.v 4/0 .tip.
7. Name, address, and telephone of person who made soil absorption tests: XoB f/e /SL t,'
Cain. PPE # /1/4
8. Name, address, and telephone of person responsible for design of the system:
SHmG A'f /2.Sev'is
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.
Date
4 Cicant
ie off Sl / efrx. 74 2
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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1 Nun` 1
1:27;( -k-7 ( F r rze
G , OL E
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
c
0 . 11;7
. (TO BE RETURNED TO HEALTH DEPT.)