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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 3 3 Q
1 A is Parcel No.
i • ;' 109 8t S treet S u it e 303
,i Glenwood Springs, Colorado 81801
i Phone (303) 945 -8212
f This does not constitute i, i,
4 i building
a a INDIVIDUAL SEWAGE DISPOSAL PERMIT or use permit.
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:i PROPERTY
( Owner's NameJktf s ROW V 1 Present Address a / t ��(e`^ "/ o 6a — 3 o` / Phone 7 r
. (2R 319 RS+ re co gl s3
; A , Sy Location { .
L 1 C pat SulT l J 1 t vh ,
'' Legal Description of Assessor's Parcel No. S
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t SYSTEM DESIGN : '
F lire) {
J /r� Septic Tank Capacity (gallon) Other
Z0 Percolation Rate (minutes /inch Number of Bedrooms (or other) T r,
21 btz Rte. - 79t c.F 1 45 a' sm. c. -MJEC 2..E.Acw 13� oR
Required Absofption Area - See Attached Sin n LEA-cfe c tohylZ Z /N i y / Z>> r •
42 3 ftM*45 s / n � ! J NFfS �z r Special Setback Requirements: p •
Dat ��� In 6^ „..,co t t
6
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( FINAL SYSTEM INSPECTION AND APPROVAL (as installed) )
Call for Inspection (24 hours notice) Before Covering Installation
f ^ 0
C I System Installer .'
f ,'. r
1L )(. 4
a Septic Tank Capacity .
Septic Tank Manufacturer or Trade Name
CdRCA4 /
I ,, Septic Tank Access within 8" of surface (
2 [l' f i
r 1 Absorption Area 'S' 7 /S I �"if I ' / " " c ' f t �''� ' .. •
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4
! Absorption Area Type and /or Manufacturer or Trade Name
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(t Adequate compliance with County and State regulations/requirements ] IA '
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,, t. Other . �-1 (� \\ ��/� /,/r�'^/�►��
Date / ' 10' (2) I Inspector ( • , >- ��'.��
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RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
d *CONDITIONS:
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1. All installation must comply with all requirements bf the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
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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- z
f nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a d !
requirement of the permit and cause for both legal action and revocation of the permit.
' c 3. Any person who constructs, alters, or installs an individual seWage disposal system In a manner which Involves a knowing and material t );
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 tine — 6 . ,
�, 4 , months M jail or both). i ,
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') White - APPLICANT Yellow - DEPARTMENT