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HomeMy WebLinkAbout01047 1� r VII I GARFIELD COUNTY B�UILII), 61 AND SANITATION DEPARTMENT i 1 Il�l r, enw ka Avenue Glood S no, 'Colorado 81601 i111µ tw Phone 30$)94543241 ^ , This does not constitute .r INDIVIDUAL SEWAGE DISPOSAL PERMIT NO I 1TA 7 a building or use permit. IL' d m p O wner Dwa A. Piper ° I II System Location Garfield Co. - near R1 le Ilik 'It ta Licensed Installer 1 'd' r IP I ' u" I I I • Conditional Construction approval is hereby granted for Qgallon III I "I ^ Septic Tank or Aerated treatment Unit.' ' I I ld I 41Ii' Absorption area (or dispersal areal computed as follows: I IS III III 1 Perc rate of one inch in r minutes requires a minimum of 1 Z S sq. ft. of absorption area per bedroom. loo M I 1 - , Xherefore the no. of bedrooms 3 x 2 . >ss q . ft. 'minimum requirement • a total of 3 7,4;M: ft. of absorption area. May we suggest /.2 7C 3.2, k 3 , 0 I I � f Date /K/4 �f � I nspector �'� CI-71f • i + 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 cover• ing any part. 0, ( Septic Tenk access for inspection and cle within 12 ", of ground swim or aerated access ports above ground surface. ©X Proper materials and assembly. s 7s �a Trade name of septic tank or aerated treatment unit. T � --air Adequate absorption (or dispersal) area. II s 4 "A Adequate compliance with permit requirements. i gic :.. Adequate Compliance with County and State regulations /requirements. Other S Date 7,4 `6/ Inspector i�i i% if; f/° RETAIN WITH RECEIPT RE ORDS AT C • N TR i. UCTI N SITE TE *CONDITIONS: II 1. All installation must comply with all requirements of t County individual Sewage Disposal Regulations, adopted pursuant to aw thority granted in 66.44.4, CRS 1963, amended 68•114; RS 1983. 2. This permit is valid only for connection to structures; I 'oh have fully complied with County zoning and building requirements { , Connection to or use with any, dwelling or structures no approved by the Building and Zoning office shall automatically be a viola. , 4 tion of a requirement of the permit and cause for both II al action and revocation of the Permit. 3. Section 111, 3.24 requires any person who constructs, a ers,or installs an individual sewage disposal system In a manner which 1n• °;^ volves a knowing and material variation from the terms, r specifications contained in the application of permit commits a Chat 1 • 1 Petty Offense ($500.00 fine — 6 months in jail or both), aI Applicant: Groan Copy C.Petmant: Pink Copy µ Page Two Fees Paid $ %I OC) INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 7 Owner: 9 u- & / //r2 • Mail Address: 4/3 g- City: R /F Zip: 6- /4St Phone:G4$'3oy 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 o ty or Town Location Address & /or Legal Description Lot Size Svs�r 2. No. of Bedrooms .3 Septic Tank Capacity / Op Q Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): pax 4Pro t Private: Well ;a( Depth �Z,, Other Depth to 1st ground water table .2-20 4. Is facility within boundaries of a city /town or sanitation district? A/C) 5. Distance to nearest sewer system: .5' e ( ( Have you attempted to arrange a connection with the system? 2 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. T1/4.A7 .3( /y */ Date Signet re of Applicant (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three _ c PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY 820 At t- 90 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.)