HomeMy WebLinkAboutApplication-PermitGARFIELD COUNTY DEPARTMENT OF E1VIRONt4I tJTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT-!
System Locationminimum= •malbr
iE'u�ixr"d
Contractor "2/
1. Construction approval:
Plans and location are hereby approved.OD9
Pere. rate inches in /S minutes+ /9® s . ft. of
absor ion arear bedrocmi.__ R —,
1 / f 0 sq. feet .! 0 s, • feet minimum re-
quiremsnt. 1 su est Q -Q �r�
Date
g 73
Ine.peator
2. Final approval of system:
No system shall be deemed to be= in compliance with the Sewage
Disposal Laws until the assemb%ed system is approved prior to
covering any part.
8" se tic tank cleanout with as seal
�.r
Proper materials and. assembl
■ �W��IW\IW -MSL
Ade.uate absor'tioEa area
Adeate concrete oo•er (dry wells only)
War1._.
Covenants signed
Date� 3 Insyector�n ofoL
** Retain with permit records at construction site.
COLORADO ;IEPART34 NT OF HEALTH
1%ter Pollution Control Division
4210 Cast llth. Avenue
Denver, Colorado 80220
Ar•PLICATION FOR AkFROYAL OFCATION FOR SErTIC TANK SYSTEMS
nit r'S
Applicant (Owner) t Rap nap" IT
Mail Address:
City: Aprtwid4h
Phones f6$ M IZ pip
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach smparate sheets or report showing entire area with ,,+expect to surround-
ing areas, topography of area, habitable buildings, location of potable water
wells, soil percolation test holes, soil profiles in test holes.
1. Location of Facility: County City or Town:
Legal Description Lot Site: 2. 3
Type of area and facility • Number of persons served: Z JeoL
Subdivision - Motel Restaurant Trailer Court
Other:
3. Source of domestic water: Public (name):
Private: Well Depth 2 s Other Depth to first ground water table
4. Is facility within boundaries of City Sanitation District:
If so name:
5. Distance to nearest sewer system:
Have negotiations been attempted with owner to connects
If rejected, give reason:
6. Rate of absorption in test holes in minutes per inch of drop in water level after
holes have been soaked for 24 hours:
7. Name, address and telephone of person who made soil absorption tests:
8. Name, address and telephone of person responsible for design of the system:
C0,9/ ,;...�,.
9. Est. bid opening date: Est. Completion Date:
Dates
Est. Project Costs
ure o • ner