HomeMy WebLinkAbout03462 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N 3 4C � i ' 1
`' li 109 8th Street Suite 303 Assessor Parcel No.
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{ ` Glenwood Springs, Colorado 81801 i
n 4 Phone (303) 945 -8212
t o' This does not constitute
) k INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. t
' PROPERTY
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} . N _-3� t �[ Owner's Namr rp1 70 '( Present Address 1 � k % l J J�1U I } TR.O. hone 4' 07? 7
' 0 • ` ; System Location 4 - . 9--
S !. Legal Description of Assessor's Parcel No.
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!i SYSTEM DESIGN r a
72/� ".
t f 0 Septic Tank Capacity (gallon) Other i i
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Percolation Rate (minutes/inch) Number of Bedrooms (or other) f ',
I 4 : - Required Absorption Area - See Attached ` ` ) I ( '�'
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I Special Setback Requirements: 1 ' ` - -��� ( �,
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\ ( � � j I `. PT./ l jut y f .
1 S- I, # Date - nom— Inspector (l �� ' 1
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t . FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
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i 4 Call for Inspection (24 hours notice) Before C ering Installation it j
", System Installer ine l47»L.) " ^' t
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;( I 9 Septic Tank Capacity ! / 000 GA i
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1 Septic Tank Manufacturer or Trade Name ,
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i r Septic Tank Access within 8" of surface ✓ • n , ;
(i Absorption Area /4
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t Absorption Area Type and /or Manufacturer or Trade Name
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�y Adequate compliance with County and State regulations requirements '. 3 Y' a-41-0(1744"17,a4 r
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L 1 Other .} 1
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t Date `n �� Inspector -'���
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i RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS: ,
p
i r 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. , :
i '{ 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- A
,, 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.
i 'I, 3. Any person who constructs, alters, or installs an Individual sewage disposal system Ina manner which involves a knowing and materiel
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine —6 4
i) months In jail or both). 1 ' ;
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