HomeMy WebLinkAboutSystem Design and Final Inspection ReportGlenwood Springs, Colorado 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
Owner's Name
lig
Permit 5 cS'4
Assessor's Parcel No.
1This does not constitute
a building or use permit.
PresuirtAddress �60l c, 3/7 Phone
System Location �[
Legal Description of Assessor's Parcel No_
'Z1 I CSU/cis
SYSTEM DESIGN
/' 217
Other
Septic Tank Capacity (gallon)
__S -15" ---Percolation Rate (minutes/inch) Number of Bedrooms (or other) ed
-/-
.
Od ���97
Required Absorption Area - See Attached 6 S� • �s
q
�//� 13/e I) -74- ea d
Special Setback Requireruents: 72�J S �•- /---/;//1/
Date ' �Qw inspector 77, % yl &sow
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity fieI.
Septic Tank Manufacturer or Trade Name
Veize/g-K ne/e c4,5 7-
C], /"e Z.-
`� /i/ 0
Septic Tank Access within 8" of surface
Absorption Area 7 2
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other r
Date r
0-601Inspector
RETAIN WITH RECEIPT RECOftDS 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