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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 3 4 q 7 '
' y' 109 8th Street Suite 303 Assessor's parcel No.
Glenwood Springs, Colorado 81801 I
;� Phone (303) 945 -8212 ll /(I/Gi
This does not constitute
j INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
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' w PROPERTY
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Owner's Name K t tb 1�RA(4. P Address Ina-) C k (2011 , . C a� lfrPhoner Sfl 1
1 r System Location 1 I-CD CRC2c'I ) beZ Cb e
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Legal Description of Assessor's Parcel No.
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I 1 SYSTEM DESIGN
w , ,, k O o O Septic Tank Capacity (gallon) Other t
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i f` 1 / 7.O Percolation Rate (minutes/inch) Number of Bedrooms (or other) 1
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i , Required Absorption Area - See Attached
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P 1 Special Setback Requirements: 6 .
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y Date S 10 ` 1 Inspector P - V•"`^S :(
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r ( FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
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I ' Call for Inspection (24 hours notice) Before Covering Installation '
fr System Installer '1 kT 1&R Is r x
Septic Tank Capacity
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Septic Tank Manufacturer or Trade Name � ..S ( ;
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Septic Tank Access within 8" of surface Y r-5
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Absorption Area 1 1 X i'c X / n r b £ YG) //
Absorption Area Type and /or Manufacturer or Trade Name F
i 1 Adequate compliance with County and State regulations/requirements y!t
i Other � �,// '.," -
Date 64- l71 Inspector ,.j/ �� a
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, ' RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
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< •CONDITIONS:
t 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. $ f
1 f 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con -
11, 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.
i R 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and materiel
i variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (8500.00 fine — 8
i > months In jail or both) ,`
—1 ; White - APPLICANT Yellow• DEPARTMENT