HomeMy WebLinkAbout03401 9
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT PermiN2 3 4 Q 1 t
109 9th Street Suite 909 Assessor's Parcel No. ,;%
' / Glenwood Springs, Colorado 81901 el* 11 1 O 1
L Phone (303) 945 -8212 I! 11
This does not constitute +-,
t INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
i PROPERTY -
! Owner's Name NcLT� C \ARlk 01) Present Address 1 )9 OO R 20 ' beSECiit Phone 72? / 7 I b � a
S System Location 3 (tlOCR2D T� �,pn e CCD .is
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t Legal Description of Assessor's Parcel No. "
1.
SYSTEM DESIGN a
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k IVY Septic Tank Capacity (gallon) Other f4
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P ercolation Rate (miriutes/Inch) Number of edrooms (or other) ,
l2.7 4 ' sr b4 C'M4Et C.4 4CFf Mb ° Q)
1 Required Absorption Area - See Attached 374 n LE4C 11 C HIMUSt k„s ) 6E RO3%4) et 23(1 w
313 0 ` LEA C H - C Rat4 / 4 rebut_ 14 s / >e4 ;a
Special Setback Requirements: A
Date g� '�3� Inspector -
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, FINAL SYSTEM INSPECTION AND APPROVAL (as installed) ,e
Call for Inspection (24 hours„potice) Before Covering Installation
tri System Installer
no,tl *- - i
P,
Y': Septic Tank Capacity /r2
" 1 Septic Tank Manufacturer or Trade Nam
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1 Septic Tank Access within 8" of surface �/ ` / 1` [tr 33
or
} ° Ab sorption Are ! 7eQ Z14-C# r/ /�y14P1 - 6 X5) 1A IJ lt�J�r3 5 4
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Absorption Area Type and /or Manufacturer or Trade Name ,
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Adequate compliance with County and State regulations/requirements t f 3
Other
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t„;; 9 f + 22 -tin Inspector _� �, _ - —
!' RETAIN WITH RECEIPT RECORDS AT C SITE
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i1 •CONDITIONS:
1 All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter V?
t 25, Article 10 C.R.S. 1973, Revised 1984.
I, 2. This permit Is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- 3 .'
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a ii ;
', requirement of the permit and cause for both legal action and revocation of the permit.
1
3. Any person who constructs, alters, or installs an Individual sewage disposal system in a manner which involves a knowing and material p
) variation from the terms or specifications contained In the application of permit commits a Class I, Petty Offense ($500.00 fine — 8
i i months In )ail or both). j
d White- APPLICANT Yellow - DEPARTMENT ___�