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HomeMy WebLinkAbout01128 d 'Ai�I'I 11 NITATION DEPARTMENT i tit'c';l"'*'r" ° +."rhn x•�r rrxYlg+w x•« w t till I �y ELD COUNTY BUILD! A t A 1i a 'yi �F ' i; dd�l , " 1 2014 ' r l' • I�flb p h" 1 1 -:' - ' 'u• lql Glenwo d S ff a odo el sot s olo Phone 4 _ 1241 111" Jr1 1 I 0 FI x a+ii�lil l u ' 1, 1 a hC a1 ^I I I i4". "- ' 1 1 atl r This do � " � ll I " lls hdt� ""�l i � i I t" r 1 Ir ° '„ I � 'l r it e I 1 ' P ERMIT 140 ' i' d jn' or u p v �I DIVIDUAL SEWAti♦c DISPOSAL 'I„ �'"��� a bu dal I Owner • Dayld AhOnIBso11 1 i , r, . . l All I'll ,I A l l u I II System Location 2 10a County Road 131 - Sill"( P i I " e 1 1 ": p„, Lic'ensed Installer hi ' " ra Conditional Construction approval Is hereby granted for tr h :10Y g t = I / —' ''( n ��_ ,,, � Hr -1,111 - xx Septic Tank or • , Aerated treatment It o W �l b Y A ll c� "", - Absorption area (or dispersal areal Computed as follows: II ' (,0't . l ill w hia, 1 " Pero rate of one inch in a minutes requires a mini m of ii sq. ft, of ebsorptiortar p e r bedroom. a Il r 41111' " II I I ; Therefore the no. of bedrooms 3 x __L......," _..,sq. ft ntnilnum requ - a total Of sq. ft. of absorption area M " ii nl 41 ". ` May we su99e}, � f y l a 9 a li " Date fu(�t /�l �- ^r Inspector + " . 'n''u' l FINAL APPROVAL OF SYSTEM: sill pp a 1�l it Iiliii,'Nl II' v! a rt u i I No system shall be deemed to be In compliance with the, wage Dis Laws until the assembled system is approved prier t711 vet i 111 I ° ' 't h l l - 4 1 .. • 41u s ing any part. 1 I C'/ 11 1 11 ' + ' 1 IIN' ©/�-- Septic Tank access for inspection and cleaning within 12" of ground surface or Oersted scoots ports above. ground 1 , 1 1 0; 1 u 1 oper Materials and assembly. f I 1Fu .r:f' f .. f rade name of septic tank or aerated tre trnent unit. f 1, i I 1, ' r Adequate absorption (or dispersal) area, /l,. 1 .2 ' Y� Q U Y...417: / _. y yr , ti IVl /"'Adequate compliance with permit re manta. 'I 1' 0 1.11 i M INI I t�� Adequate compliance with County and ate regulations / requirements. i" Ha 1 l 'l Other �. 11, 4 Date /I de / .. ` . I Inspector 1,`4'a.. , 4 Il ll il, ' RETAIN WITH RECEIPT' R r CORDS AT CONSTRUCTI "ON,SITE Iai IIh�'l l i "CONDITIONS: "1" I' 1. All installation must c with all requirements of " Il i e o tt� Individual Sewag Disposal R egulations, adopted pursuant, to aU, + d i 1 d"� '„ thority granted in 66.444, CRS 1963, amended 66•`3 'I S 1963, ll' i 1 ° "n, 2. This per it is valid only for connection 10 structures s n "1 II l l f av 'fully pomplied County toning and building requirement$'f mi Connection to or use with any dwelling or structure ■• t pr by the Building an Zoning office shall automatically be a vlole " ", I " tion of a requirement of the permit and cause for b 000 acti and revocation of the permit, fl ' Ito 3. Section 111, 3.24 requ any'. person who construct , 'i It ers , or inst alls en indivi sewoge dispos system ina manner whi iin: elr ii1' volves a knowing and aterial variation from the te r 1 l or specifications contained In the application of permit commits a Claass ,L ".° lu, I" ' Petty Offense 1'3500.0040e — 6 Months in jail Or both ri ' . d 1 .1,. III . "1 111 1 I�01 uh "p' Applk.nt: Orlin V t■apartmint: Pink Copy _ ,f i,1 t s lball . v , . .k , w .u.._y_.w.._.. ." v ... ruWl'la_+Vlfra,.ru.+u+..wr _ Page Two Fees Paid $/5040 INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date //_ 0 , d 1 Owner: fptile. A.ntnim‘Pckn i Mail Address: 3 /Oq Co %e0 331 Cit S /CT Zip:8I6SZ Phone: 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 5 /L7 Location Address & /or Legal Description 3'oyca.Q13. Lot Size .7 AC, 2. No. of Bedrooms Septic Tank Capacity 11:6C Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): Private: Well x Depth i3o Other Depth to 1st ground water table IC t 4. Is facility within boundaries of a city /town or sanitation district? t,_)0 5. Distance to nearest sewer system: .5 pi Have you attempted to arrange a connection with the system? a 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. 11-2_ _ 8/ Date Signature of AFI 1 an (TO BE RETURNED TO ENVIRON. HEALTH DEPT.) Page Three PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY Ck.. , to/ 33/ INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES ✓�( \\ . 0 ' f f . , i I i j ,, i , G o„ 7. � ,Q d s c (TO BE RETURNED TO ENVIRON. HEALTH DEPT.)