HomeMy WebLinkAbout00149A (O-z -7
GARFIELD COUNTY DEPARTMENT OF ENVIRO. NMEN £ACTH
2014 Blake Avenue A, nnva
Glenwood Borings, Colorado 816')1 N ,Lt4 _ 5 /
PERMIT* 149A
L-vv, CA , , . (v . 2 S alto
System Igaation ✓� r >„ „5r-/ . n G-- . Sn,s�� F � j
Contractor Tic -sa . A/ /f/J/o7 G5 _
1.. Contraction aporovat for a _ %CCO gallon Septic tank
Aerated treatment unit
and absorption area computed as follows:
Pere rate / Mahe. in ..5 mtnutee- /aSeg. ft, of
ebmirptiog area oer taedroom. 63-) -
3 X /mss NI. feat- 3 7S” *a, feet minimum reoutrement.
I Qua Qt /a'-k- 3cR .X 3' Sr_agea
Date a5 - - 73 Incpector •
?. Final approval of Priam:
No *Totem *hall be donned to be in compliance with the Sewage Disco'al
Law' until the assembled 'totem i* approved prior to covering any cart
� thereof.
cootie tank ateanout with app seal .
1 t4' PrQoet material* and acReelbly
I t'�� Ad#ouate abQorotion area
Adeeuate concrete cover (dry well* only)
N� `ovenenta •lgned •
1 _.
Date IU '/1'73 Inspector
** Retain with oein•tt teoord• at con*tructton cite.
• tmont L. Kinkade, Sanitarian
Garf. Co. Environmental Health
2014 Blake Avenue Tel. 945 -7255
Glenwood Springs, Colo. 81601
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIIVVrDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: 9Fin ` _% i £o
Mail Address: / mot' , 5 5` City 7ipf /65O Phone-4 . 0
A. INFORMATION REGARDING PROTECT SUBMITTEDD FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable buildings, location of potable water wells, soil percolation
test holes, soil profiles in test holes. Q
1. Location of facility County City or town ,2 �e�"
Legal descriptiordte, 3O 4rlib S.S 4 9/ 4.1, Lot size j! 9s 124.cc.e.c_
2. No. of bedrooms .� Septic tank capacity Aeration unit capacity
3. Source of domestic water: Public (name):
Private: Well X Depth / ther Depth of first ground water table XS:
4. Is facility within boundaries of a city /town or sanitation district? 2t0.
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system? 7?�
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes per inch o��
in water level after holes have been soaked for 24 hours SCZ PER t
7. Name, address, and telephone of person who made soil absorption tests:
8. Name, address, and telephone of person responsible for design of the system:_
S Z� Eck ?.CA -ct
Date Signature of Owner
*Required by Article 66 -28 -12 (CR:S, 1963, 1967 Perm. Sum. Supp.)
**Required in areas which have been identified as areas in which danger of pollution of
waters of the State may ogcur (Art. 66 -28 -8 (5), CRS) and /or areas in which there is no
local septic tank ordinance.
Please use the following space for directions to your property site.
Ci ffttis
O p eirei t 64—
1
4
• ti� 1
ur n yea