HomeMy WebLinkAboutPermit InfoGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
- 108 Eighth Street, Suite 401 & 0 <7
Glenwood Springs, Colorado 81601 Permit
Phone (970) 945-8212 Assessor's Parcel No.
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
This does -not constitute
a building or use permit.
Owner's Name �.��L y �c��s i Present Address/7% -u�Phone61 2/ff —
System Location
Legal Descripxion of Assessor's Parcel No. % Q -� C7 ®� S'f
SYSTEM DESIGN
0S'0 Septic Tank Capacity (gallon)
$ Percolation Rate (minutesrnch)
Other
Number of Bedrooms (or other)
Required Absorption Area - See Attached Se .1 //V 7*5my -/- :3S Q ¢-
Special Setback Requirements: - jr% SQ, /��,� 11V
Data _ - Z-3 - f � ^_ Inspector �%/t!l /"V// 4SC7 fV
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity 0
Septic Tank Manufacturer or Trade Name r— r,)
Septic Tank Access within 8" of surface
Absorption Area . _ , ;? 2R? -25 _c
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with 75:7
regulations/requirements
Other /�l // 2:714 cx�
Date %.- _ Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Hoard of Health Individual Sewage
Disposal Systems Chapter 25, Article 10 C.R.S. 1978, Revised 1984.
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 or a requirement of the permit and cause for both legal acfion
and revocation of the permit
3. 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 contained in the application of
permit commits a Class 1, Petty Offense ($500.00 fine - 6 months In jail or both).
White -APPLICANT Yellow- DEPARTMENT