HomeMy WebLinkAbout046Ala mac,. q uGARFIELDCOUNTYDEPARTMENTOFENVIRONMENTAL. HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
p{1 PERMIT N S 046 this does not constitute
rnW x , ` •1 "1 1 a building or use permit)
Owner Witte
System Location. OL4 e rha - nr
Licensed Contractor La.e . 4-41 ktt-WS
Conditional Construction approval is hereby granted for a /Pelt" gallon
Ss-Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate inches in d' minutes / sq. ft.
absorption area per bedroom 7VM't e
0 of bedrooms 3 x qo sq. ft. minimum requirement S s4.. ter
May we suggest vir (OA vwerzc)
Date S a'at yy Inspector i!
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.
Or Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
mVe Adequate absorption (or dispersal) area.
arc -Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Date 77 /Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTIDN'SITE
CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.444, CRS 1963, amended 664-14, 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 Hermit and cause for both
legal action and revocation of the permit.
8. Se91ion III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a magnet' which involves a knowing and material variation from the terms or specifications con •
tained in the application of permit commits a Class 1,4 Offense (8500.00 fine • 6 months in jail or
COLORADO DEPARTMENT OF HEALTH
Water Pollution Control Division Building Official
4210 East 11th Avenue
Denver, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: Q Vs o he.. #UAt
Mail Address: an </ ?`/City(nJeAUen,ul1 Z1p4,ceRP Phone9f/JT'a' /.?L
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of area, habitable buildings, location of potable water wells,
sol1 percolation test holes, soil profiles in test holes.
1. Location of facility: CountyGorpit /t City or town(o)¢vuicidel_
Lery, n , Ti r.S C g?P4 LoT M•
Legal description :Se Lot size 3,;'
2. No. of bedrooms 3 Septic tank capacity/000 Aeration unit capacity
3. Source of domestic water: Public (name):
Private: Well Depth gQ Other Depth to first ground water table '45
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system: 4
Have you attempted to arrange a connection with the system? MO
If rejected, what was the reason?
6. 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
oFn
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:
List Li /4 CA.hoAiet&L.•f3
Date Signature of Owner
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 which there
Is no local septic tank ordinance.
B. SIGNATURES OF LOCAL OFFICIALS: The undersigned have reviewed the notification
described on the front of this sheet and reconthend approval or disapproval of
the discharge as shown below:
Date Approval Disapproval
Signature for Local Health Department
Signature for City /Town Official Title
Signature for County Official 7Titier
Comnents:
Signature and Title
Note: The Notifier (front of this sheet) must obtain comments and signature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer:
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP•33(10-72 -2)