HomeMy WebLinkAboutSystem Design Specs 12.27.2018GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 401
Glenwood Springs, Colorado 81601 Permit -53- 7S-
Phone(g70)g45-B212Assessor'sParcelNo.
INDIVIDUAL SEWAGE DISPOSAL PERMIT'This does not constiiute
a building 0r rrse permit.
K/Ad presenrAdd,"",Tep .f,¡lþ( //¡¿êphoneæs=%7*
Legal Dcscriplion of Assessor's Parcel N'' Z + * 7A Z3 aoaTg
SYSTEM DESIGN
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SePtic Tank CaPacitY (gallon)
System Location &r4€
PROPERTY
Ov¿ner's Name
"Z { Percolation Rate (mínuies/i
Requíred Absorpiion Area - See Attached
Special Setback Requirements:
Date Z'Z lnspector
FTNAL SYSTEM ¡NSPECTION AND APPROVAL (as installed)
callfor lnspection (24 hours notice) Before covering lnstallation
Other
-4s
/-s
System lnstaller
/z-tP Gr4 ¿,Sepiic Tank CapacitY
Septíc Tank Manufacturer or Trade Name I CY
Septic Tank Access r¡¡ithin 8" of surface Y tts
Absorption Area
Absorption Area Type andior Manufacturer or Trade Name s
Adequate compliance with county and state regulations/requirements \tø5
Oiher
Date 1-7 lnspector
RETAIN WITH RECEIPT RDS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requírements of the Colorado State Board of Health lndívidual Sewage
Disposal systems chapter 25, Article 10 c.R.s. 1973, Revised 1984.
2. This permít 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 oflice shall automatically be a violation or a requirement of the permit and cause for both legal actíon
and revocation of the Permit.
3. Any person who constructs, alters, or insialls an individual sewage disposal system in a manner which
involves a knowing and materíal 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