HomeMy WebLinkAboutSystem Design Report 05.02.2019GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 401
Glenwood Springs, Colorado 81601 Permit
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner73:44/1/A
s Name
System Location
Assessor's Parcel No.
This does not constitute
a building or use permit.
Present Address 665 C4 Phone 6Z -5---Z3
Legal Description of Assessor's Parcel No. Z ( 7 7&-,/ z O ' 4- E2.
SYSTEM DESIGN
10
Septic Tank Capacity (gallon) Other
Percolation Rate (minuteslinch) Number of Bedrooms (or other) 3
Required Absorption Area - See Attached o 51 7 /Ai � ' � �� ` C -c-3
Special Setback Requirements: ± T/ 1 /A/ 'e'e 9 b 3,C S.
Date 1 Is— / 9 Inspector_ 4/74moo
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer_
s�� r ,5,4 /eXcA,
Septic Tank Capacity
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8' of surface
Absorption Area
• Ye, .54? //i/ T 'v2 /1
Absorption Area Type and/or Manufacturer or Trade Name
3
1
Adequate compliance with County and State regulations/requirements
Other 2p o ? /ale/ a --477g:. 2k i //-%ii
Date :s — �� 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. 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
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