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GARFIELD COUNTY sUILOI ' AND SANITATION DEPARTMENT
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1 1^ IN ''DISPOSALPERMIT 1 111 6 abuNdingoruseperm
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'ji V Conditional Construgtion Approval is hereby granted idr it gallon
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' I I r id . Septic Tank or Aerated treatment It.
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1 l Absorption area (or dispersal area) Computed as follows: (,1- ' 1 11p1, ^an I
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•r. " I "sw i' Pet c rate of one inch in minutes requires e mini m of /ate sq. ft. of absorption area per bedrgom.e, t f 1I ■ 41 ) l' arl_
yg the no. of bedrooms x ,. , : Iniimum,requirement • a total .0 ,Q sq. ft. of absorption er6al ,,111
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1,. May we suggest / *d � 'J Ei9c# ,� y i � II
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IP 00,1NI,L AP OVAL OF
w 1 . 'No syst m shall be 'deemed to be in compliance with the "I6 age Disposal Levj until the assembled system 1s approved prior to cover y r1 ° I I .
I1 ,1 ing any art. 1
,Y ii Septic Tank access for inspection and ql. him) within 12" of ground surface or aerated access ports above ground i 1. 1 II',"
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Proper,snaterlals and assembly. '' '
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�1 /r/Jir.4 Trade name Of septic tank or aerated treatment unit,
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Adequate absorption (or dispersal) erect: , ear "
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Ad equate compliance with County ana to regulat /requirements.
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11 I RETAIN WITH RECEIPT R ' ,a RDS AT CONSTRUCTION SITE
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l I$ '" `1. All installation must orgehplyi with all requirements of t "County 'Individual Sewage Disposal Reputations, adopted pursuant to au• v 1 6
- +, thority granted in 664 -4, CRS 1963, amen 64 fRS 63 r 1 T" 1 ii
411 I 2. This permit is valid only for connection to strueturesk " c h f ully complied".vvith ,County zoning and building requirements ; -rl)t 1'
Connection to or use with any dwelling or structures," 1X1 by the ,E tiding and Zoning gfflce shall automatically be a viola .,,w
tion of a requirement of the permit and cause for 1b t , I and revocation of the permit, I I, I wl-
I L 3. Section 11I, 3.24 requires, any person who cortstru 11 •r` fl an individual Sewage disposal system i n a manner which m y , k, I u
'4i, volves a knowing and material variation `from th e 4 s 1 11 ecificati contained In the application of permit commits Class 1,' 1 ` F_
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Petty Offense IS60d.00 tine 1 4'”' months in ail or b
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• INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION [Date g //9 l8"/
Owner: /YJ le//AEL r efiA.EZ five SWV,' oc
Mail Address: /?o, Box 307 City: /SARA -cNvrc Zip: g /63s Phone:A8S-7n94 `
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 PAAA c w o TC
Location Address & /or 64V7 cr`,Q4. zoo- 8wsq .raw'iJi,
Legal Description J. r, / rw,, If ten Pb w 6 ,on Lot Size 90 /watt
2. No. of Bedrooms .Z Septic Tank Capacity / 00o Gnc Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well v .- Depth .3.2O / Other — Depth to 1st ground water table ASO'
4. Is facility within boundaries of a city /town or sanitation district? A/0
5. Distance to nearest sewer system: 6 ihit Ps.
Have you attempted to arrange a connection with the system? /v O
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:
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7. Name, address, and telephone of R.P.E. who made soil absorption tests:
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8. Name, address, and telephone of R.P.E. responsible for design of the system:
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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.
rA9 hi/ ,( ` , Sere of Applicant
Date
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
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, RODWAYS, AND BOUNDARY LINES
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0 (10 BE RETURNED TO BLDG. & SANI. DEPT.)
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