HomeMy WebLinkAbout01020 ARF1 COUI�TV I Q tV SANITATION TMENT
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+ Phone $03) 11 945.11241 41 241 1 S c. It 6 Y
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L1 '.INDIVIDDAL SEWAGE DISPOSAL PERMIT t1 1020 a builds " perm . d " "
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1 I owner D an Hughes (' Mal - r svn) 9'4 r 2 s� ' :I,
i System Location 0269 Wil low Lane - Carbondalig II -
1 v, Licensed Installer (/ lit) h PP i/, c rd 7 /716 , e ,
Conditional Construction approval is hereby granted fora t V gallon D k es 0 8_ 0
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1 SeptidTank or _,_Aerated treatment unit, ( ®` e � p i
V h I Absorption area (or dispersal are computed as follows:
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11,1 . Perc rate of one inch in inutes requires a minimum of 'I'^ sq. ft. of absorption area per bedroom.
It. Therefore the no. of bedrooms x sq. ft. +,minimum requirement a a total of sq. ft. of absorption area.
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y May we suggest �l °t: Qe � h ci' � �cYd f-9tGY0 r e/l / /✓1 y 'I '
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,• Date 3 .. , . _ 1� ` '' InsPectoi 1 4C _ /� 41 tom... . 1.
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° FINAL APPROVAL. 0 T
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— yp . s stem 11e stem shell Q n9 t b 4 ,complian e with. e Se Disppo a Laws until the assembled system is approved prior to covet- ` 9
ng a Pq(t, r . � ! `
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J issorr 7 � C7 Ptic5 f»ate i1tt a -i p i for i t nand Ina Whin 12'• of ground surface or aerated access ports above ground
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I e ' IOA Adeq to absorpti or di4Oa11 a a, 1 k ��(/ ,Ie e+�s' +
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t�K yAdgquate compliance 'th .rmi aquirgments.
'Adequate compliance with County and State regulations /requirements.
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I II I 4 Date t/4/if / 2 3-C Inspector / , AA - ___
1 _ RETAIN WITH RECEIPT RECORDS AT ON$TRUCTION SITE / s ' a1 ,
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r " CONDITIONS:
1. All installation must comply witirall•requirements of the County Individual Sew Disposal Regulations, adopted pursuant t evi I
thority granted in 66.44.4, CRS 1963, amended 66.3•14,ICRS 1963. 's c
1 I„ 1; 2, This permit is valid only for connection to structures ichlhave lfully. complied tth County,'{oning and building requlrement"s ^h: 1
- Connection to or use with any dweliiil'g or gtmictures np approved by the Building and Zoning office'shall automatically be a viola• Ir
tion of a requirement of the permit and cause for joth I • al action and revocation of the permit, a
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Page Iwo Fees Paid $fiS7o
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• INDIVIDU HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 6,-S E
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Owner: n., / �trD thA /r�q �m
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Mail Address: - 54? /44 � ioo/ a /Hart).{# City: At,I �/�Oe_ Zip: V4,24 Ph :9/,3. ,2,57/
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 (see Page 3).
Near What
1. Location of Facility: County GARFIELD City or Town _____ ___d
Location Address & /or /J
Legal Description Q,z19 LU, ;AO,eul, .,, „( e Lot Size t, m/A /.ni
2. No. of Bedrooms 4 3 Septic Tank Capacity Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well )( Depth Other Depth to 1st ground water table 3 -'yz '
4. Is facility within boundaries of a city /town or sanitation district? ffp-
5. Distance to nearest sewer system: ‘ eyyx,y.t. a,- n - n /,, /
Have you attempted to arrange a connection with the system? yu,
If rejected, what was the reason?
6. If R.P.E. tested, state 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:
7. Name, address, and telephone of R.P.E. who made soil absorption tests:
8. Name, address, and telephone of R.P.E. 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 Building & Sanitation Department and /or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Building & Sanitation Department.
10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula-
tions of Garfield County and I hereby agree to comply with all terms, conditions and
requirements included therein.
" ?ea4126 /Y -
ate i:na ure o 'pp scant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
2 PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI- , s
BUCION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
E '41,00°
- - - - -- 516. 5i
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.2.00 /aCRe5 �-
I 14
1 _ 02700
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(TO BE RETURNED TO BLDG. & SANI. DEPT.)
