HomeMy WebLinkAboutApplication- Permit4
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20Th Blake Avenue
Glenwood Springs, Colored° 81601.
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C,)nstructrio;► }i,r:►val:
Nlan3 and location are hereby approved « 7` 7 Sd S.l#-p ('41oO.4491rst
k`e l rates ine es in minutes* /25- sq. ft. lqf
aiyaor }tion area Aer bedroom.
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1k, s. d eet ,e 25--e7 ag. feet minimum re-
uir'ernent
Date 76 7 3 Inspector
Final approval of system:
No system shall be deemed to lac in compliance with the Sewage
Disposal Laws until the assemb:Led system is approved prior to
covering any part.
se }tie tank cleanout with as seal
Pro r materials anc7. assembl •
r7:::1 Ada nate aUatalczi area
137 Ada uate ccnncrat e.:
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Inspector
*4* Retain with permit records at construction site.
r7 COLORADO DEPARTMENT OF HEALTH
later Pollution Control Division
4210 East llth Avenue
Denver, Colorado 80220
APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS
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Applicant (Owner) : TPa ,J 4 ,7 Ofp i ( i L0'
Mail Address:2Y° 6?2.20^6v P'-' City:6i0✓1-aa1D4) Phone:'gS— 5731
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,
soil percolation test holes, soil profiles In test holes.
1. Location of Facility: County c- 4. f i E L c City or Town
SW IZ -l.'.J I�► I -3 T7 S Lot Size: 3. ( 1 k 'Z- 5
Legal Description W� P.m
2. Type of area and facility - Number of persons served: 2�"7> ®, s
Subdivision 7'. Motel Restaurant Trailer Court
Other:
3. Source of domestic water: Public (name):
Private: Well x Depth Other Depth to first ground water table
4. Is facility within boundaries of City or Sanitation District:
If so name:
5. Distance to nearest sewer system: /U%/Lc,s
/0
Have negotiations been attempted with owner to connect:
4i4
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: /",,t) S' M/./vTt.s
7. Name, address and telephone of person who made sol sorption test
2'r) if,/riikJ6errEL PxoP'c7-S, 2-,vc . Gl i
8. Name, address and telephone of person responsible for design of the system:
9. Est. bid opening date: Est. Completion Date: Est. Protect Cost:
Date: YY1 1 / 477.3
I '
�V �
Signatureof wner
8. SIGNATURES FOR LOCAL GOVERNMENT OFFICIALS: The undersigned have reviewed the'
proposal for the location of the above-described septic tank system and
RECOMMEND APPROVAL or DISAPPROVAL In the space provided below:
DATE
Comments:
APPROVAL DISAPPROVAL
/-7 / /
Signature for Local Health Department
Signature for Mayor or City Manager
S gnature or County Commissioners
Signature and Title
Note: The applicant must obtain the 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 -I0 (Rev. 5-70-100)
r
2014 SLAKE AVENUE
GARFIELD.. COUNTY
ENVIRONMENTAL HEALTH
13LENWDOD SPRINGS, COLORADO S1601
J r. Donald Supitilov
P.G. Box 312
Glenwood Springs, Colorado
PHONE 945-7255
Dear Mr. Supitilov,
The enclosed copy of your individual home sewage treatment
system permit should be sufficient documentation that said
system was constructed and approved according to the laws and
regulations of Garfield County and the State of Colorado.
If we can be of any further assistance, please do not hesi-
tate to call.
Sincerely,
Ed Feld
Department of Environmental Health
Garfield County
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enclosure