HomeMy WebLinkAboutFinal Inspection Report and Site PlanGARFIELD COUNTY BUILDING AND SANITATION L)EvAFi i MEN 1
108 Eighth Street, Suite 401
Glenwood Springs, Colorado 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
Permit 2 / Z
Assessor's Parcel No.
This does not constitute
a building or use permit.
PROPERTY
Owner's Name Ptiv P4 Xs Present Addresses 07 Cie
System Location
Legal Description of Assessor's Parcel No. Z % Z 3 &-
SYSTEM DESIGN
Acb 0 _ Septic Tank Capacity (gallon)
Other
Phone
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached 700
Special Setback Requirements: `P • " //V 70 1/41)7'5 - 9 -
Date / -V/ .� _ inspector Le - s49 /
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System installer
m r� 4% CZ, 'S
Septic Tank Capacity _ 4/-77 4 C
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface _
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other /� 7f -- .
Date
— 2 %' 6 Inspector
,s
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage
Disposal Systems Chapter 25, Article 10 C.R.S. 1973, 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 action
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