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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit
278
109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
PROPERTY
Owner's Name Michael & Stephanie DetN$ Address P.O. Box 28697, El Jebel Phone_ 927-8310
System Location G S 4 4 County Road 331, Silt
Legal Description of Assessor'sfparcel No.
2.0 (,C4CH F(C -P --^—) ! 6 rG rr
SYSTEM DESIGN t, G A, C N a N N an 661- (3 CV ) 9 Q I if
T n &t C PAS r_ b 1 C fr
1 2 5 0 Septic Tank Capacity (gallon) Other /
If rte. S 3 \6Fr / (&J
1 -V) Percolation Rate (minutes /inch) Number of Bedrooms (or other) 4 ` //
O a
Required Absorption Area - See Attached O , ` � `� � ) 1 V SE a 1 l ( O L r ///C4•
1
Special Setback Requirements: - �C
kt c. 6 ASr' C Fr A PI) it r NCNC�S
C, Date - ? C. -91 Inspector / -e-- , ( 1 2,. I A K , t NI C^A_ tit L"NC(rl
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer 2 C ^ /1 c v .
" Septic Tank Capacity 1 2 . 0 p.
Septic Tank Manufacturer or Trade Name C+ ` �) en t c A 010 Septic Tank Access within 8" of stirface ( 1 ) 0 ( ` y -
j Fr A v
Absorption Area 1 4 ✓ (Fr I r t T . A 7 0? K 2' y 7
Absorption Area Type and /or Manuf or Trade Name ° ► I - C7r2. 1
Adequate compliance with County and StatQ'regulations/requirements V (r ----- --
Other 1 NST 0 (3 iItt ((a. dok 2/
Date O 9 J ( Inspector /' r
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a
requirement of the permit and cause for both legal action and revocation of the permit.
3."111a� person who constructs, alters, or installs an individual sewage disposal system In a manner which involves a knowing and material
rlation trom the terms or specifications contained In the application of permit commits a Class I, Petty Offense ($500.00 fine — 6
.'44....,„4: �. on ths in jail or both).
�^°
White - APPLICANT Yellow - DEPARTMENT
- INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER '' ItLhtlal.4-_ 4iPlkii De 1(th dr\
ADDRESS o (1...(4-000 ?P I091 �/TEP # I ( G g l �� PHONE 970 - 917- 8314
CONTRACTOR A (nus ( . ('fl/l in •
ADDRESS 17/0 4'A,J04) Rt Y— S tl t (c) St PHONE 47o— R7(- 1930
PERMIT REQUEST FOR (6 NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area,
habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY:
Near what City of Town [ L.ti�" Size of Lot S . 3910 /1Ce&S
Legal Description or Address
WASTES TYPE: ( DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: �E�(1k�� C—
Number of Bedrooms 9 Number of Persons 4
VI Garbage Grinder Automatic Washer XI Dishwasher
SOIJRCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 7 m t LA - C
Was an effort made to connect to the Community System?
A site plan is req uired to be submitted that indicates the following MINIMUM distances•
Leach Field to Well: 100 feet
Septic Tank to Well: 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System to Property Lines: 10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED
WITHOUT A SITE PLAN,
GROUND CONDITIONS:
Depth to first Ground Water Table et)
Percent Ground Slope
2
. ili I
64 zi,
5-i0 ,1/4 4----_ all Ki\
if t331 ga
.1}011 Do ye.D')
N
liff.
M 11 o
Tuoivio of( 4.5 ',Jilt s 0 rwxEL i
t�(uv(� 51.394' pica s
b53(P -331 szb
IN 2.tego2
COLONNA CONST. CORP
1710 Grand Ave.
Sift, CO 81652
en‘ -1930