HomeMy WebLinkAbout03392 Aar- r
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• G ARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N^_
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109 6th Street Suite 303 Assesso 's�Parcel No.
r 1 Glenwood Springs, Colorado 81601 y Earei1.lt 761 7
Phone (303) 945 -8212
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1 This does not constitute
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� INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. A
PROP9RTY . ���
7, r Owner's ,a — 11G �/ �� Present Address CVO- 1' Ra ` 'i LT
Phone W7h0 - 'NO Cl t y
l i. System Location CS • • a . •. . -- ► °. - _ . Ital ` 111, " t
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' Legal Description of Assessor's Parcel No.
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SYSTEM DESIGN , f
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r : f 2D NI u Septic Tank Capac (gallon) Other 51„,:-.
^ 3 1 Percolation Rate (minutes /inch) Number of Bedrooms (or other) Qi 6/t/gB014 DO • '
k Required Absorption Area - See Attached 4_ 1 1 —01 R,7 . A k ?a (' �, / v /1 1/,(( // , u y
3 Special Setback Requirements: 1 'f 1! Si Fr REQ u_i [E NV • b / �^-w V
:1 ( D ate �' f'O Inspector l� c f �^ clil^'C I Jt $t / !.
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FINAL SYSTEM INSPECT! N AND APPROVAL (as installed) S� d4J� 4
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` Call for Inspection (24 hours • •lice) Before Covering Installation
a 1 System C. AL -tar Li,. ' ' —
Septic Tank Capacity _ :
Septic Tank Manufacturer or Trade Nam a • ' t
• v Septic Tank Access within : , , . ce 1 \ = " - -' ' At
Absorption Area ,, I + (_ f ' w t• ':- " + - • , •-- �. I CI _ _•,+ t v,
Absorption Area Type andr Trade Name _
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@ ` @ "r Adequate compliance with Cou and State regulations/requirements Y ,
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' i Other . I -i ...ri• :0 . ..e r , • E. . 1Ftt. N ' L. L ... r`
Da te •..•.i.. Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTI' SITE , l
• *CONDITIONS: +:
t h 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter y i
25, Article 10 C.R.S. 1973, Revised 19b4.
j'• Z 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- .,
r 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.
a 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material i.,
variation from the terms or specifications contained In the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 ' ! months in )ail or both). / i )
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' White - APPLICANT Yellow - DEPARTMENT