HomeMy WebLinkAboutApplication-Permit11
7,01‘e/iso
,e„ 77o 3
..,._.':!' A.J.J.,a') i•��4,�iV 3 Y Dr..%.t3RTmrltiT q'"41G1 A' '!
y s 2014 B ak:: J v&nvi:�:° Q
Gird>.'.wo d. S `.rags, l`�} �C 7 01-1-iiC �l 1{�
...!�..1`04.!`N— < N%A .''kHT1 G .
•..:ti.i approval .for a '%S® (fa r .;; :4 : 374.i yy1,r1:Z
...�.. a.. A. .'..o,
L; A ..i. U_.'1iUn area computed cc.. follcvs: .rte
in ;1:es :9.. i 37 minutes a"r'l. ft. :7f.
.v.:;c pO..c t area
pe 7 bedroom__ /�
sq. feet 4 S7-0'�t� . L. "rct t
2: E`.poroval of System: tA,.
Eo systemshall bel L Gcit';-d to b°3 in cromJl. ;'.'.r.
i:i.: 0o3a1 Laws until the z:ssetIblc.d rs •st:l is :p '�'=;!� ps-5.cr :a
G:3Sy part thereof.
''.M septic tank cleanout; with ges so,1.1 .,
[ _ ..__..,.,_Prokt . materials snd assemblyrTir .... _._.� .. w s �..u........ .
Adcs,taate ahsorlAtian area
_..._ Ade3yatp concrete roves: µ(.lr.�r_w11 sonly)*
_.._._ �...._ ..n..._�_-�..�...,. ._...... im: p...........r
[4/09' 1 Covenants si5ned.
4 ogAls a&T? 7-C) r9-radc-Vl11-160
R 'TAT" WITH »k'.F',Mr::" ?,. eO t.t?r= AT crIsl '??[1C"1"'To ,C
yi/ "--/9-10..---.0„e--- OR /IR`t 4C9E
5e -6 -42,f -e-- #3
•
COLORADO DEPARTMENT OP.HEALTH
-Rater Pollut.jon`Coritrol Division
4210 East 11th Avpnee
'Denver, Colorado"80220
NOTIFICATION OF PROPOSED; 1SCHARGE TO,WATERS O THE STATE*
' . I ND I V I DUAL HOME "EWAG..E TREATMENT SYSTEM**
Owner: 5Trti,(
Mail Address: "`
C I ty COLO Z I P 6160/ Phone 9 -,
MeaelIVI
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: c , 11Wa034
Attach separate sheets or report s;owing entire area with respect.to surrounding
areas, topography'of area, habttab a buildings, location of potable water wells,
soil percolation test holes, soil "profiles to test holes.
1.
•
Location of facility: i ty: County}61d, . City or town) • oFagiz,,p..
a "a lit
Legal description :arrr 74•=10., Dt'7j'2fJ ; . 'Lot size' 3p4
PerrPse.tterD '1 L.{?�v. P 1 ir. a Y G-41.) au g rcI73
2. No. of bedrobtts a Septic tan capacity ()OO Aeration unit capacity
BMW
3. Source of °domestic water: Public (name);,
Private: Well Depth . Other Depth to first ground water table
is facility within boundaries of a city/town or sanitation district? O
Distance to nearest sewer system:
Have you attempted to arrange., connection with the system? X10 R
If rejected, what was the reason?
Rate of absorption In test holes shown On the' location map; In minutes per inch
of drop in water level after holes;.have`been-soaked for 24 hours
,SALT
Name, address, and telephone of person who made soil absorption tests:
5e'P-tZ'vcir
Name, address, and telephone of pej son responsible for design of the system:
A , ,
De Signature o ner ,
I el /iemo
• *Required by Article 66-28-12 (CRS, 1963, 1967 Perm. Sum. Supp. )A , C ridSir
**Required in areas -which have been Identified as areas in which danger of pollution
of waters of the State may occur (Arte66-28-8($), CRS) and/or areas In which there
VS no local septic.,tank ordinance;
-.......nth...
• .
'•••:,'• •
::•1;
••••••••!,
SIGNATURES Fd: 0 Fl 1ALG: "Ph mndsi-slred have reviewod,the notification
esct e Or: 0 rout 0 t s shici, and recommend approval or disapproval of
the discherge as shown below:
' • ' , iiii
Date • -.,ApOrovel. ' Dleel5tirov,P1
• 4,
Comments: • .
'• r.1
•
•
4
"aFiTUFiTor Lotal Health Departmer?t.
',. •
S rT t " " t
Signature
for.County Official (Titlel
• -;•".-
. .,..• .••.
• -1•1•.-i. ' • -
• •
•;1'.
•
+'•1111 '••• 'CIII;•• •
, •
•
• Signature and Title
Note: The Notifier .(front of thisffiaet) must obtain comments and signature of at
•
least one of the above.
.. ,. ,
FOLLOWING FOR STATE HEALTH DEPARTMEOT'USE: .Recommendatrond.of the District Engineer''
.1. :
4:.
•
•
••4;• •
' ..'• '•
•
•
' .
D. ACTION BY THE COLORADO WATER POLLUT ON CONTROL COMMISSION:
•• •••, • •••-
•
• . ••• •
• •- •••.•
r
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT # S 031
Owner �' OriA Y cel ()-
System Location NO ear bL1 t
#Licensed Contractoe f*"'14d. LT tri•
(this does not constitute
a building or use permit)
* Conditional Construction approval is hereby granted for a
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate
inches in.. minutes sq. ft.
absorption area per bedroom
gallon
# of bedrooms x sq. ft. minimum requirement
May we suggest
Date Inspector
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.44.4, CRS 1963, amended 66.3.14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County Zoning and
building requirements. Connection to or use with any dwelling or structures not approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the permit.
3. Section Ill, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Cass I, Petty Offense ($500.00 fine - 8 months in jail or
both.