HomeMy WebLinkAboutApplication- Permit4a1Sii
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 9454212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit
4162
Assessor's Parcel No.
This does not constitute
a building or use permit.
Owner's Name ire -Q—) Pho
System Location
Legal Description of Assessor's Parcel No
SYSTEM DESIGN
Septic Tank apacity (gallon) Other
Percol. ion Rate (minutes/inch) Number of Bedrooms
Required Absorpti. Area - See Attached
Special Setbac Requiremen
Date Insp
FINAL SYSTEM INSPECTION AND APPROVAL
Call for Inspection (24 hours notice) Before Coy
Sept Inar
Septicis Tankk CCapacity
Septic Tank Manufacturer or Trade Name \�,
Septic Tank Access within 8" of surface �(mj\/\
Absorption Area
Absorption Area Type andlor Manufacture
Adequate compliance with County and State regulations/requirements
Other
Date
Inspector
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. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning off ice 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 I, Petty Offense (3500.00 fine —6
months in jail or both).