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HomeMy WebLinkAbout01050 � m I ""' I. ., 4ARr'IEt.O COUNTY I4U�, ' 11 tm 11 'N, it tioIi acPARtM ENt '� I I r " II �1 g rl ...n! ! • fig I I ° "I olenW ° r 1 ` II I ' I � , d o si8o1 I ' 1 • ] � a f.. 1 tl �� + 1§ ' • , "° 111111 I W l I gill IqR' , V ''Ill 1 11 4 1 r1 , r r t "w a V 5 1 li1� � 1I9' l y i w11 1 This does not constitute' r Iµ 11 "�� # 1 (� UAL $Eaht}# II r010p; ,t, PEA MIT N 1111' • building or use permit, I t ` di xr 1 i �4tl � I IIIII"l `1 " i .^ 1 s'1 I 1 Stijl ," Strauss 1h1I 71 11^ u 4, 1" ,1v" 0i 1 • l"" J � , I. d° Ii I ! `k l a I+ VI]hII ' ,. t • �e , I t! Napd - S1�t II k "DS yy,,t ' Loca 4 � , *: y 1 I ualry^' r I III 1, 1 / f 11 °1 — Si r " 1 , .�, qe M Ip$taller i i 4 � ' 1 1 w "r4d11 '1114'411i' III a r t 1 1 11,1 w 1 1 Oo�Id hslryctioh,aPpfbyal h hereby Brenta l c r , l g allon ° " „ I ° + 1 r I t' l I v, 1 °' 1 /` „ Septic Ta11k qtr , p jr, i Aerated treatrn0i$ l lit „111 i i �I� ,119 " '1,pn (or dlspar l i C omputed as follpvff4 ” 1 w g l i 1�1 siI1” M 1 7 1 l d' / . In 1 4 yRi., 11 1 � Pere' re d tlN I a 1 IO 1f o nN 1 � IR m � slttri requlras a n61 '� i, h�,�r}' sq. ft of absgrpt " Ir00 per bedroom. w � 4rcltl 1 l u 1 u 1* p 1 I -5 W "�� hlrefor0 the 11# r . I!, ,,,, , x 2 " / y 0tj yowit' in aye�q{ ui� rp tn { ant • • a to of l y Sq, ft, of abs a :A 1 I �l d lµ " , :"' I 11 ,, `Tl tl ! i" IM 'li 1 + "A I „ I I'i✓ J ' ` + * IA " 1 11 ,1 May we suggest 1 11,1' / . � I w MIS C -� o d , ' w a i h�4 p 4 v/ / /t' " y,�w� • / yam _ Iltl V 1 1 'Date v } k ' Vr+ 1 I'� Inspector O i" V` - .../ °I hll 1111 II WW .. I l lliil 1 1 1 1 r� t 1 1111 et II "1 LI1 {ii 11, INAL APPROVAL D � ; 1 1 III � "y1� + 190 I/110,, 1 1i 1 1 . 1 0.1 I.1 i 0 1 1 Iiiil; Gtl Na s y s tem shall 1 1k be � sompliar ce NMi1h ktA e' itp¢sal Laves until the assemple'„system is Ipproved prior t "�p r ll 1 4 1',In any part 1 1 ; � 1 4 1 011r r 1 tl _ '. P pa p el 4 s f ssembl ahp p1 I dG Alkbin 12'" of ground surfe or p8rato�l access ports above grgUitd 1 11 l ��,, Tre7 }t �� tl tank or BarCf� nt '1t 0 4�• t 1 I I d 11 r IVr �r 1 1 ua. I � . F'� A d 1 Ua"La a4 or dIf parl4 l lare l � , r " i l i �' 1111+ 9 1 r 1 u1 V 1 , 1Itl1 1 ' Q " A " dpque 6a Co m pItance with permit t Qt il 4 ILIts ' 1 ' "Mil1,,,,,,,,,- m a. © /.� �6 a 1" w w t II �.Il r IIII 1 iC A'depuat0 cornpllenc0 with County 1 apd, � V,ri r egUlatipns /re I s C rI "111 9 tl1� l� Other a �1 r " 117 '' +w / v L _'. g I, 1 Date 7 14. 0 r G S 7 1 1I I , Inspp ptor Ai, . I.I'�. id • 4ETAIN WITH RECEI e $ A T O RUCTION SITE B E f d �11 X r;�' "' N I i a � �. w , � . a 1 r n + 1 +,111 toONDITIONS: 1 , t 1. All installation must com . with all requirements 1 i ,5. Al "; zel "Sewage Disposal R @ gulau dj ts, adopts pu rsuant o au+ mI thorit ranted i 86 4 C S o $3 emende 6i 2. Connection to b wi1h or stru i " ° t by the a ldin i nd Zoning per d ffioe shall auto celly Ibld , Jt +` t of a requirement of 00 permit and cause fot 4 • �r I " ti 0 rid revocation of the m it 3. Section 111. 3.24 retlulte a0611 Ftiereon who con$tr ° , I i i 1 1 " o i' g 1 6011; en Indivipual sewage dipposal system iii a manner which ih ; . i volves a knowing end mel0ria7 V a riation from the tt r t i yt, l} ° ICetibns t bntelned 9h the app of permit co a Class 1 w., 1! s Petty Offense 1$60Q,00 f'Iri a l5 mon in ta or blIth I1 w 1 1 g, 'III iP c al 4l rid APPIlollnt: orMa " ° , 4AM' r < It+� h tt Pfek COPY ° 1l rdge Iwo Fees Paid $75 _4.5 INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date f-,.3- H Owner: eI lt y 04 �7 J Y'011,4C- Mail Address: 04,2( Ste/ City: �; �f Zip: 6:46$1.2_ Phone :fl- ?Y3f INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW 6a21"M, 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 2: / Location Address & /or Legal Description C)55'4 a /(, 4' Lot Size /G ar re S 2. No. of Bedrooms 3 Septic Tank Capacity /00 © Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): Private: Well X Depth Other Depth to 1st ground water table 4. Is facility within boundaries of a city /town or sanitation district? /(/O 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 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. EA* . Date ignature of pplicant (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three 1 .411% PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY _ g us___A. d X -1444 aka Zek d d 47ca< 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.)