HomeMy WebLinkAboutApplication - Permit/---. ,..-
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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 8160 I
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PERMIT # S 040 (this does not constitute
a building or use permit)
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Owner·_....~l.l,_r...,~,bf!..:<:J~n....l,.._~Qo!!::..l:u:!.!J...L'n~i:>::....... _______________ --=-__
System Location ::Pc:rn oriim > C ~l e. sa B-t l & 58 C.. 02::2 4 ~
Licensed Contractor ~k-Gt--'"&?,. C:::.::XaA-cl/lzZNb
* Conditional Construction approval is hereby granted for :;,o;o~ gallon
~Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate_...,.... __ inches in Q).'• minutes67~.:;,~o~ .. __ :sq. ft.
absorption area per bedroom'""""'.-n"'"',_., ________ _
~£
# of bedrooms x sq. ft. minimum requirement / /. ,-,
$ ;;o o -ro Po SG? ,ry-. /'A BJ.fiJJjfl<>t+"
May we suggest , / 1 .,, ·d B./!.0 /.:ll ,)<.,:J"8 1)(3 f2:...~ ...:2~· ¥.!X 9' )( ~-S~r~..G
Date • c "' Inspector_..,.s,·,-c·.,..,;~· -;.:c·.;.· <::"~/L/.-----------J-78'~ 71" •;:-... / ',, ., .
FINAL APPROVAL OF SYSTEM· OJ€ -rt<.Jo -r~c:.r11=-s 3-5/~N~ s"vN~b72.. ///?G
. /1--N 0 OJ / t<.J/ 0 6'
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.
-"'~:p...::.. __ Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
-'"&;<:.o;z:.~---Proper materials and assembly.
-=~=-==-----'Adequate absorption (or dispersal) area.
_..:.pg;:::...c:=. _ _.Adequate compliance with permit requirements.
___.('4:;..a1<":...-=-__)Adequate compliance with County and State regulations/requirements.
Date__.Z<....:....-_,So.::__~....::7~,f.:...._ ________ Jnspector ---"&4::....;.~~~-:.!:~~--=---------
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· ~~t~~d in the application of permit commits a Class I. Petty OffensP ($500.00 fine • 6 months in jail or _______ (
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11f-'-.~OLORIIDO DEPARTMENT OF HEAL Tli
Water Pollution Control Division
4210 East 11th Avenue
)env.o·, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
I NO IV I DUAL HOME SEWAGE TREATMENT SYSTEM•'<>\
Owner: tL/?64d __ ~~~U.::./~·IYr....rr-_~!iirl:'r1'77e;:;<.S:VZ:: ___ _ ;;Jii'( 121" I BPJ< :s:rc::
Ma 11 Address: %Ju ?fldd!At6-Sf. C I ty RtFt-f.-_zIp /16.0 Phone J?~-:.Z!Jf
A. INFORMATION REGARDING PROJECT SUBMITTED .FOR REVIEW:
Attach separate. sheets or report showing entl re area wl th respect to surrOlondlng
areas, topography of ur~a, habitable buildin~s, location of pot~ble water wells,
sol 1 percolation test holes, soli profiles In test holes.
1, Location of fa ell I ty: County fiAJ?E.IIEW> .:.City or town_ Su-r
Legal description~~~ Lot sIze~ dt:-,I!.U
2. No. of bedrooms_~.&.~---·Septlc tank capac I ty/tf~M ,Aerat ton unit capac:i ty ___ _
3. Source of domestic water: Public (name): ______ _
t!~t..-
Prtvate: Well..JL_Depth __ Other ___ ...:Depth to first ground water table ____ _
~-Is fact !tty within boundaries of a clty/tm~n or sanitation district? JVO
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S. Distance to nearest sewer system: ~ /IIIII £$
Have you attempted to arrange a connection ,;fth the system?~M.......,~::.....--
If rejected, what was the reason? O«r oP CtTZj ?teUT.£ ..
6. Rate of absorption In test holes shown on the location map, In mlnut•.s pu l~'ch
of drop In water level after holes have been soaked for 24 hours ___ _
7, i"a;r,e addrr,ss, and telephone of person who made sol 1 absorption tests: ________ _
sc=='?£ e~L.I:::
8. Name, address, and telephone of person responsible for design of the system: ___ __
*Required by Article 66-28-12(CRS, 1963, 1967 Perm. Sum. Supp.)
**Required In areas which have been Identified as areas in which danger of pollution
of waters of the State may occur (Art. 66-28-8(5), CRS) and/or areas In whic.h there
Is no local septic tank ordinance.
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B. SIGNATURES OF LOCAL OFFICIALS:
described on the front of this
the discharge as shown-below:
Date Approval
Comments:
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The undersigned have reviewed the notification
sheet and recommend approva I or d I s?.,>prova I ~·f
Disapproval
Signature for Loca I Hea 1 th Depiir"6nent·--·
Signature for City/Town Official (Title)
Signature for County 6fflclal (Title)
Sl~nature and Title
Note: The Notlfler (front of this sheet) must obtain comments and signature of at
iens 1. or.o c-f the abo·Je.
C. FOLLOWING FOR H/,"."E HEALTH DEPARTMENT USE: Recommendations of the District Engineer:
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D. ACTION BY T~~LORADO WATER POLLUTION CONTROL COMMISSION:
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WP-33 (10-72-2)