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HomeMy WebLinkAboutPermit CardGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 401 4 5 3 Permit tin?. r(':!1;atc.f.eas...b Glenwood Springs, Colorado 81601 13 Pd 12- 5\ ce Phone (970) 945-8212 INDI,3st m IDU� SEWAGE DISPOSAL PERMIT PROPERTY Owner's Name hits System Location 0 Present Addres V 4 sv. Legal Description of Assessor's Parcel No. SYSTEM DESIGN This does not constitute a building or use permit. ! , Phone 2 l 8_1621-4- -tY--A--trarD15 Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer I Septic Tank Capacity F Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area CT Absorption Area Type and/or Manufacturer or Trade Name 72Q) I Adequate compliance with County and State regulations/requirements j 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. 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