HomeMy WebLinkAboutSewage Disposal PermitG^RFIELDCOUNTYBt-III.DINGANDSANITATIONDEPARTMENT
108 Eíghth Street' Suite 401
Glenwood sprinss, c"'*äätiãìonr Permit fZ^e
phone 10rc7 a+u-irlz Assessor's Parcel No
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner's Name
This does not con stitute
a building or use
3 CK.Z5'-7 Phone z¿'a- 8S/S-
Present Address
System Location
Legal Descripfion of Assessor's ParcelNo'
SYSTEM DESIGN
/ Z^5'A sePtic Tank caPacitY
Other.
Date
Z/Z 7s+z -¿eo ->0 /
Oiher(gallon)
G Percolation Rate (minutes/inch)Number of Bedrooms (or other)+
Required AbsorPti on Area - see Attached 73-st Sq'trf a/ f,<prcr/ * éz Q-*=
Special Setback Requirements 582 s<,Ê#/il FEP+ H kls
Date --> .-/7 -./a tntp"ctor 72/4 lÁ,// Lsa¿'/'
(as installed)
Callfor lnspection (24 hours notice)Before Covering I nstallation
System lnstaller---.-.---.---.-
Septic Tank CaPaeitY
Septic Tank Manufacturer or Trade Name
'ithin 8" of surfaceSeptíc Tank Access w
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and Siate regulations/requirements
lnspector
RETAINWITHRECEIPT/RECORDSATCONSTRUcTIoNSITE
GONDITIONS:
1. Af r instaration must compry with arr requirements of the cororado state Board of Hearth rndividuar sewage
Disposatsystem= cnapiei 25' Artícle 10 c'R's' 1973' Revised 1984'
2. This permit is valid only for "onn""iion
to structures which have fufly complied with county zoning and
buirding requirements. connectío;i; ",-
use with any dwelling or structures not approved by the Buifding and
Zoning office sha, automaticary be a vioration or a requiremãnt of ihe permit and cause for both regar action
and revocaiion of the Permít'
3. Any person Who consiructs, alters, or installs an índividual sewage disposal system ín a manner whích
invorves a knowing and material variation from the terms or specifications contained in the appfication of
permit "o*ri,, . ð1"=, 1, petty offense ($500.00 fine - 6 months in jaíl or both)'
White -APPLICANT YEIIOW - DEPARTMENT