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T. 17 9 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N^ 3 4 1 1 ,
109 8th Street Suite 303 Assessor's Parcel No. '
I. Glenwood Springs, Colorado 81601
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Phone (303) 945 -8212 . r
This does not constitute ri
f 1 ' INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. ! i
r� PROPERTY `
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t `. Owner's NamI,\(t/ k A Present Address au 5 I - R1 V r Phone 4,7c -2J1 I r, ,
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System Location in t — 6 . • r ', ;
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Legal Description of Assessor's Parcel No.
l 2 Rock mite/sib/its -.r. Igo } SYSTEM DESIGN
(' 1 r /Al AV 44* /k ' 7 ,ElCb
r / COO Septic Tank Capacity (gallon) Other
. / Percolation Rate (minutes /inch) Number of Bedrooms (or other)
, ' i Required Absorption Area- See Attpched
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t Special Setback Requirements: �
i ; i Date Inspector z _ V Inspector eek '
I FINAL SYSTEM INSPECTION AND APPROVAL (as installed) 4C
Call for Inspection (24 hours notice) Before Covering Installation
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t S ys t em I ns t a l ler I I' t L�� '
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Septic Tank Capacity L
'. f Septic Tank Manufacturer or Trade Name C.S1 2. Lis net'
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Septic Tan Access within 8" of surface /
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1 Absorption Area ig- 2% - t ^
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t , Absorption Area Type and /or Manufacturer or Trade Name .. 6.}
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Adequate compliance with County and State regulations/requirements .
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?t. Other I �/ �\ F ■
'' Date � 1 Inspector ^' 3 1 r t
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 1
' *CONDITIONS: 4
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- ii ■
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 i
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 iisposal system in a manner which Involves a knowing and material f
t ; variation from the terms or specifics n of permit commits a Class I, Petty Offense 8500.00 fine — 8 r
months In )ail or both). f
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