HomeMy WebLinkAbout03626 • • 4
,r r_r •
RFIELD COUNTY BUILD AND SANITATION DEPARTMENT Permit N2 3 6 2 6 f
I 109 8th Street Suite 303 Assessor's Parcel' No.
X 111 - /r Glenwood Springs, Colorado 81601 ,
' I 1 1 , Phone (303) 945 -8212
,
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. +
'. PROPERTY r n ' �/. ��� 'Cl , r - Phone P
• 'c Owner's Name? t I Iul.aJ 1�11✓ � Present Address P a S C ' - 3 3 `�" k 74 •.p 7 �.
� °^ 31 It, C-O 'i(.S"2 9-1s -4y II "
System Location 1 t (CI0 C.Ae 531 ) '
Legal Description of Assessor's Parcel No.
i
SYSTEM DESIGN
y `
f ox C,A m"JSeptic Tank Capacity (gallon) Other
Z3 Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 ,
crap sta- Rau C7 -,1c4! Fin. 24 Required Absorption Area - See Attached 453 ,o, ti - I- .1-40-/ CASWI$ZQf - 24 N Msr ' iftikkC /,
3 ` > G r 544 �j F; " ii 2 9 uu,>7 X 2>
Special Setback Requirements: 2 r y d r 5.'44 37 ,$ a 1 ' , t 34 uu,V) - 23,Ty
• Date ) -) - Q L Inspector X1.5. I•• I Lc 'I FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
' Call for Inspection (24 hours notice) Before Covering Installation t
System Installer \J - 1.IN.1 � (AV V a -t '7 "t'v11)
Septic Tank Capacity , O00
Septic Tank Manufacturer or Trade Name l \ \ -\ l)y "/ 4 ) 0
Septic Tank Access within 8" of surface l+ A-- �/ �? - o `
1 _ .__ i_ _ I 1 .
' JY✓i-- .L4/1•-i- R 1
• Absorption Area 2 h/Y./. te a-
J
Absorption Area Type and /or Manufacturer or Trade Name 1..4 / �,..4 MA G1 '
Adequate compliance with County and State regulations /requirements t4 ,e/- -- •
Other ,
Date - 15 c ' Inspector 4 ' ) 4 . ' - '& / -
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter t
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- A 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 '
requirement of the permit and cause for both legal action and revocation of the permit.
3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material - i
variation from the terms or specifications contained in the application of permit commits a Class 1, Petty Offense ($500.00 fine —6
months in jail or both).
. if 5
0 ite - APPLICANT Yellow - DEPARTMENT c i.