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HomeMy WebLinkAbout01025 f ,, , , GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT _ 2014 *lake Avenue if Glenwood p(303) 61801 945 8241 Phone • This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT b4 1025 ' a building or use permit. Owner Lee Bernier System Location 0569 Sun Kinn Drive - Lot 27 - Mina 2 - Daft Meadows • t Licensed Installer /4/42P/P-0:4 /C b �� f • Conditional Construction approval is hereby granted for a 1 anon gallon X Septic Tank or Aerated treatment unit. • • F Absorption area (or dispersal area) computed as follows: Perc rate of one inch in 15 minutes requires a minimum of .190 sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms ._—.1__. x 190 sq., ft. minimum requirement ■ a total of 57n sq. ft. of absorption area May we suggest Leach Field 12' x 48' x 3' deep or 18' x 2' x 3' deep. Date June 23. 1981 v Inspecto .../, . // /J . _ . FINAL APPROVAL OF SYSTEM: / No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cove• ing any part. ID K Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground ii • surface. _ 0 4C Proper er nd asse bly. , . d a � , etotA.. /VCICO of •t_�, © Tra na a of septic tan or aerated treat nt unit. `� + 1 1 •Q r A dequate absorption (or dispersal) area. �g X 3 2 ' f r"1 s e G r , e!^- Adequate compliance with permit requirments. O fr■ Adequate compliance with Cobnly and State regulations /requirements. Other / n Date R R Inspector .Ai...- 11 JAI ,. . _ RETAIN WITH RECEIPT RECORDS CONSTRUCTION SITE lf 'CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au. • thority granted in 66.444, CRS 1961 amended 66.3.14,IiCRS1963. 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 no'S 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 pny person who constructs, alters, or installs an individual sewage disposal system In a manner which In volves 8 knowing and material variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (S500.00 fine — 6 months in jail or both). v Applicant: Groin Copy p.p.rtm.nt: Pink Copy Permit. i! 1025 CHAR L ee B ern i er II, .t Name of Applicant d i i� Percolation Test 550.00 Amo , unt Paid S75•09 ., r ? V , (includes final inspection) , I k' Permit Piocessin. Fee $25.00 ,L Date Paid June 23, 1981 " Si ii ' 'I T ni L Serwoo i',. r � � eck X (1 Cashier 4 i ? Sherwood , .'.tr= p r . 1i d i u aft t , 'n l o neY Order ALL CHECKS ARE TO BE MADE PA v ABLE TO GARFIELD COUNTY TREASURER ' Treasurer: Receipt white CoOY+ . )1040t:.Qrpn Copy D+plrtmMt fink COPY '? " nil 1 2' 'w.bda:.g.;eaa `E.,.....,.t..' £ ._..,ea ,...,: }3.t.:.so1ir<.au.r. .7- .1/2.,kdAd7 eb , S.a,.t. `dea " ,k1.,:. . :.,3'xd. ih :.«t:,,tit,..a&ETn -- +, A..a tt-'t.. ..... as,..0.,s . e..' _i' a :- Page Two Office Use Fees Paid $7S INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date (9 R Owner: % Mail Address: AX /71 City: CM/Odd°' Zip: i /02- Phone: S:1.2/ 7 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 Legation Add ptso & /or ( ) 0 4 )/0/tier- /'it Lot Size Legal Description �7 vi v?. ,q- 2. No. of Bedrooms 3 Septic Tank Capacity /1SZ i� Unit Capacity N/A 3. Source of Domestic Water: Public (name): 6617W4444 Private: Well Depth Other Depth to 1st ground water table 4. Is facility within boundaries of a city /town or sanitation district? /Zp 5. Distance to nearest sewer system: /VA- Have you attempted to arrange a connection with the system? 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 rtlade - 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 j... 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. 6� is Dat ig,r ure o 'pp lean (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY . � fz r l v p r- r INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI- :I 1 1 1 . 1 . , I1 j . . Al :4111,.. 1 • e 1:17 • (TO BE RETURNED TO BLDG. & SANI. DEPT.)