HomeMy WebLinkAbout01030 1
w ig i A I, � +l � , _ GAftFIELD COUNTY BUILDING AND SANITATION DEPAhTMENT
4 20114 lake Avenue
" `• . , Glenwood Spngs, Colorado 81601
,, s Phone 03) 845.8241
,
I , ' This does not constitute !
r '' INDIVIDUAL SEWAGE DISPOSAL PERMIT 0 1030 4 a building or use permit. . 4 4 1 �."
Owner .1, LL Hoary µ
ihi System Location 3944 Sweetwater Rnad Cis L tr-. k A\ QA i fil-
' Licensed Installer W
• Conditional Construction approval Is hereby granted for 411 , / / n f7 gallon
11 II
Septic Tank or Aerated treatment unit
i t
Absorption area (or dispersal area) computed as follows: ' r ,
OI
Parc rate of one inch in minutes requires a minimum of sq. ft. of absorption area per bedroom. Pi
" I Therefore the no. of bedrooms 2 >< sq . ft.lminimum requirement a a total of ` / 6 n jS sq. ft, of absorptl area.
May we suggest (A I * S 6 .p:; �a I I A 3`� 3 I
tg l II
R
� � I
Date ' V'Cst 11 '�E , it l I ns pe ctor , 0( 1
I+ ,
FINAL APPROVAL OF SYSTEM: �'1��
No system shall be deemed to be in compliance with the Se wage Disposal Laws until the assembled system is approved prior to cover- ` ;,Y±
Ing any art.
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. l' • - ,'
Adequate compliance with permit requirements. • �
Adequate compliance with County and State regulations /requirements.
Other
Date d• Inspector
,
RETAIN WITH RECEIPT R AT CONSTRUCTION SITE
• 'CONDITIONS: i
1. All installation must comply with all .requirements of the County Individual Sewage Disposal R adopted pursuant to au•
thority granted in 66.444, CRS 1963, amended 66.3.1411CRS 1863.
2. This permit is valid only for connection to structures ich have fully complied with County zoning and building requirements fu
Connection to or use with any dwelling or structures no approved by the Building and Zoning Office shall automatically be a viola• '
tion of a requirement of the permit and cause for both I al action and revocation of the permit.
3. Section ill, 3.24 requires any person who construed, a l ers, or installs an individual sewage disposal system In a manner which in. `
1 111 1 c volves a knowing and material variation from the terms 'or specifications contained in the application of permit commits a Class If `
Petty Offense (5500.00 fine — 6 months in )ail or both). , ,
Applicant: Oran Copy ban /rtmant: Pink Copy - r
Page Two Office Use
Fees Paid $7S
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date (0
I I
Owner: �� , �1 EN i21
Mail Address: 390 ,S,alFp�Ia)H�ee c t City: CtSIlM, en Zip: Phone:
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEEWW
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 _
Location Address & /or c ,
Legal Description c7 111 p , Lot Size ,.-.),;),() ax.j1Q>a•
2. No. of Bedrooms 2 Septic Tank Capacity /000 Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well Depth Otherpp1'1 Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system:
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 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.
Date o f a " re . i pp
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
° wny 7 &P (3°
cra
opi
, 6p
I
2 6/ X m;
A ° 2
`S 0 7
r
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE.RETURNED TO BLDG. & SANI. DEPT.) '`