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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT # 8 090 (this does not constitute
a building or use permit)
Owner Cnlnradn Host Land A !Development % Bob Carmack
System Location Asgard Subdivision. 2nd Filing. Lot No. 1
Licensed Contractor '/PP/ E) o19Grni.7'/A141'
* Conditional Construction approval is hereby granted for a.�_1224L gallon
Septic Tank or ' Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in /5 minutes /Po sq. ft.
absorption area per bedroom 77Yne
0 of bedrooms . ? x _Zsika sq. ft. minimum requirement = .9••7 %%tit l 4 .r..ee1t
May we suggest t. 'x 4 3/ se z 1 - 45e10
Date /0 —7— 7. Inspector �' �'�� •
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
- Proper materials and assembly.
Adequate absorption (or dispersal) area.
tC" Adequate compliance with permit requirements.
6 - _Adequate compliance with County and State regulations /requirements.
Date 4 — 10 - 7e Inspector e
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 86.44.4, CRS 1988, amended 88.3.14, CRS 1983.
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 of a requirement of the permit and cause for both
legal action and revocation of the permit.
3. Section III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation fronPthe terms or specifications con-
,
tained in the application of permit commits a Class I, Petty Offense (8500.00 fine . 6 months in jail or
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COLORADO DEPARTMENT OF HEALTH
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G' Water Pollution Control Division
421Q East 11th Avenue
Denver, Colorado 80220 •
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWA TREATMENT SYSTEM
Owner: do/ E44 »ex/ LiAd belle % e i(/ �i/
o`7E & 0'XINti C i t � c ! o o _ Z i �T IG G/ P hone C AA l COI
Mall Address: Y P
A. INFORMATION REGARDING PROJECT SUBMITTED. FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography 07 area, i1Jb:t ul G'J11 ir:y , 1ocoi. ion of potable water wciis,
soil percolation test holes, soil profiles in test holes.
1. Location of facility: County G�j41 e /% .City or town o N e
Legal description 6 ((ALv 4?ct / H.ws,Lot size 4"7/ 7q lo Ct tr 4.41-
2. No. of bedrooms . Septic tank capacity/e ° Aeration unit capacity
3. Source of domestic water: Public (name): g';/
Private: Well `\ Depta Other Depth to first ground water table �/
4. Is facility within boundaries of a city /town or sanitation � diistrict? /145
5. Distance to nearest sewer system: Sl /( l 0( 0 -- 10 7 drier
Have you attempted to arrange a conn with the system? / V!� •
If rejected, what was the reason? /VD A(Q
6. Rate of absorption in test holes shown on the location map, in minutes per inch
of drop in water level after holes have been soaked for 24 hours •
See R k ?t ll.iT
7. Name, address, and telephone of person who made soil absorption tests:
• Sere C R4AX Cr
8. Name, address, and telephone of person responsible for design of the system: ad
Date i gnature of Owner
*Required by Article 66- 28-12(CRS, 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 occur (Art. 66- 28 -8(5), CRS) and /or areas in edrich there
is no local septic tank ordinance.
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B. SIGNATURES OF LOCAL OFFICIALS: The undersigned have reviewed the notification
described on the front of this sheet and recommend approval or disapproval of
the discharge as shown - below:
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Date Approval Disapproval
Signature for Local Health Department
Signature for City /Town Official (Title)
Signature for County Official (Titles)
Comments:
Signature and Title
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Note: The Notifier (front of this sheet) must obtain comments and signature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTF: DEPARTMENT USE: Recommendations of the District Engineer:
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D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
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WP- 33(10 -?2 -2)
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