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GARFTE:Lll C;OUTrFF F:TNI'OR /rid n'AL I IE
2014 BLAKE AYL,tiUE;
tia.N;JOOD SPR1 IGS COLOR 'U
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL / SYSTEM PERMIT
RECEIPT It `�"- sr
/c - ...� ('/ /c Co to 4a tip
OWNER: Del yr a I4_ - Y - L.t tt ADDRESS:__ j ...etc,._ r .__PHIONEr 7is
CONTRACTOR: ----- S r ADDRESi;; PHONE:
SITE LOCATION: (7J .0 /t _a_rGer Non OF UbDRCXfl S; SIZE OF LOTS /e *avrtiS ..
Application for an individual sewage disposal pp q permit is hereby submitted., The
individual sewage disposal system will be constructed in accordance with the
regulations concerning individual sewage disposal systems within Garfield County°
This appiication is valid for six (6) months from date s,r.gned0
DATE: a* ef . 4 .4 9 //pt.g. ___ SIGNATURE: erssse 4 ,2,,,4,E
PerctOrti.irn test results: Minutes per. inch:
Recon u;,nded minimum size of leaching systen :_�
Reconm..unded minimum size of tank:
PLOT PLAN
DATE SANITARIAN:
Ifortirrir Tom'
1 ".
4sme4
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OWNER C c:Le 0 70 b re r-c ite3 e I-
CONTI 'UR __S s - 0 . —
9 r. _s. te fr
SITE ; c. re
Appl, C rr4 ion for an knalvictunt „c 11 1 n d " The
indJ al sowagt c;lsosal • r r o , the
•
regu.acions coacert ,nq indvIc) •-.0 k - IL 3 " ta" Garflet County,
This ft, ct.'"ion is val ie for c.h) "'() n I L r s r
DATE. ru Ai um _ cr-sees-g_
Percolation test results: Minutes per inch:
Recommended minimum size of leaching system:
Recommended minimum size of tank:
PLOT PLAN
1 / 4 1
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DATE1 SAlaTARIATI:
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