HomeMy WebLinkAboutApplication- Permit11--.7:3 1 5c)
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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Permit 4 2 6 8
Assessor's Parcel No.
This does not constitute
a building or use permit.
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Owner's Name 1 Present Address -C1 (_ 1 �- ) Phone I ("' _� 3 t v�
System Location �_O`�I ") t/ /17 l (c 3 uj
Legal Description of Assessor's Parcel No
15-L! — 06 co 7
SYSTEM DESIGN
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached -'`J ee/
Special Setback Requirements: 19/4- - �J
/// .2 ceps'
Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
./.220+0 T--(itt�L 7 , -
System Installer
Septic Tank Capacity
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 //
Date 3/ /// Inspector // ` l .t^�!n
RETAIN WITH RECEIPT RECORDS AT CONSTRUCT ON 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 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 I, Petty Offense ($500.00 fine — 6
months in jail or both).
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