HomeMy WebLinkAbout01091 GARFIELD COUNTY BUILD1 AND SANITATION DEPARTMENT
b y t+ 2014 ke Avenue
Glenwood Sp rig*, Colorado 81601
Phone , 93),454241
1
vi This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT NI Pi 119 a building or use permit. 1
Owner James Pareglen L A
System Location 4 Miles South on pry Hollow Road 331 4 C -e. 49/ sa.et ,
Licensed Installe
' Conditional Construction approval is hereby granted for Ai 1.000 gallon
X Septic Tank or Aerated treatment uhit.
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Absorption area (or dispersal area) computed as follows: i i q
Perc rate of one inch in _1.3 minutes requires a min) � m of 't ? - Z.aq. ft. of absorption area per bedroom. Ip
// : 11
Therefore the no of bedrooms 3 x L 2Zsq. ft. Inimum requirement • a total of 6 272 , 6q. ft. of absorption area. r i
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May we suggest e-- T '''' & if II 1 `e
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Date (/l 2 + gt r : Inspector LJrcn
F SYSTEM:
FINAL APPROVAL OF
i ' No system shall be deemed to be in compliance with the StIWage.Disposal Laws unlit the assembled system is approved prior to covefi'" i1
ing any pa III J_
0 - Septic Tank access for inspection And claming within 12" of ground surface or aerated access ports above ground :
R I. surfaces 1 :
tO Proper materials and assembly. i r.
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Trade name of septic tank or aerated treatment unit.
I Adequate absorption (or dispersal) area. i t
r51C- Adequate compliance with permit requirements.
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OK.. ` Adequate compliance with County and Sete regulations /requirements.
Other :
� I _ _
Date �� � 1 et l A/ i Inspector � -. / � , Z
f
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE ,
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"CONDITIONS: ■
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1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au•
thority granted in 6644.4, CRS 1963, amended 66.3.14 CRS 1983.
2. This permit is valid only for connection to structures ich have fully complied. with County zoning and building requirements.
Connection to or use with any dwelling or structures n6 approved by the Building and Zoning office shall automatically be a viola•
tion of a requirement of the permit and cause for both 1 al action and revocation of the permit. 1
1 Section I11, 124 requires any person who constructs, Al$ers, or Installs an individual sewage disposal system in a manner which in
volves a knowing and material variation from the terms'or specifications contained in the application of permit commits a Class I,
Petty Offense 15500.00 fine -13 months in jail or both).'
in Applicant: Oran CopV 'Dapartmant: Pink CoPV
us ..... �.......... Y.u,y.,... -.. +.. w................ ...,..........rr..r...-- �i.a.... .— .- rri....-°
Page Two Fees Paid $
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date
c.
Owner: \99IUO or I
Mail Address: 20 2Y3 City: /t/.0,4195 /' Zip: P /6V7 Phone: 9 ?
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 �,l/
1. Location of Facility: County GARFIELD City or Town _Co. o d 7""
Location Address & /or �
Legal Description ? miles . So. okay /64/ Rd 331) Lot Size 2a.cveS
2. No. of Bedrooms ,3 Septic Tank Capacity /,}()U Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well Depth /50 Other Depth to 1st ground water table /V/ /+
4. Is facility within boundaries of a city /town or sanitation district? /t/0
5. Distance to nearest sewer system: yykiLiS
Have you attempted to arrange a connection with the system? A/0
If rejected, what was the reason?
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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.
9 -23 -S/ J M l C Ce
Date Sign re of Applicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
• , PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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ta , , .p,bes ___ . __ ----). _ --- - Lu g)
Y(0"1.06 / 7- 7 dk_
F1'r . a //u� , �
�llq,A. Ilw5 Ci cck- --:`,N
(TO BE RETURNED TO BLDG. & SANI. DEPT.)