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HomeMy WebLinkAbout00181 4 *v i " GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL. HEALTH 2014 Blake Avenue V Glenwood Springs, Colorado 81601 REPAIR PERMIT H 8 IL Sit (this does not constitute a building or use permit) Owner D. C. Van Dnvnnrsr System Location Tract L. Chelvn Anent Licensed Contractor 4.0/0 c=am lm /� ) C . * Conditional Construction approval is hereby.gtantet for a /'��ngallon (. E,e 6l ffi k Septic Tank or Aerated treatment unit. • Absorption area (or dispersal area) computed as follows: • Perc rate / inches in , 0 minutes °? / sq, ft. absorption area per bedroom F0Gl2 11 f bedrooms '1` x cP /O sq, ft. minimum requirement �'�D 5 r�' G/ o 770 /9`r'1 May we suggest -Ywfo p r 0G .<- f�9`G"TL -flt a / GU /O E K•5e5z • ,4 U /rS7R - Date i 2 S Inspector �' l 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. 0 , 0 " Septic Tank'dleanout to within 12" of final grade or a e r a t e d Proper materials and assembly. Adequate, absorption (or dispersal) area Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. t'. Date Inspector 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 66.44.4, CRS 1988, amended 86.8.14, CRS 1963. 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 viold'tion of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Section 1II, 8.24 requires any person who constructs, alters, or installs an individual sewage disposal o system in a manner which involves a knowing and material variation from the terms or specifications con- twined in the application of permit commits a Class I, Petty Offense ($500.00 fine • 6 months in jail or both. 0 /? a - eao' -C ` COttSADO DEPARTMENT OF HEALTH C q 5 `-- ' : Water Pollution Control Division 421Q East filth Avenue Denver, Colorado 80220 ' NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE* INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ** • Owner: DC VAIN PE Mall Address: $01e 7 _ City. Zip Ace Phone .2'y,5 331 A. INFORMATION REGARDING PROJECT SUBMITTED FOR RE 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. 1. Location of facility: County /EvD, .City or town 6?Lsw/.r/ndlo SPGS Legal description T �� A I y � ��QE5 Lot size 9. 3Z ". 2. No. of bedrooms Septic tank capacity6i10, unit capacity 3. Source of domestic water: Public (name): __ 1 Pri.'ate: Wellg DeptlY3C) Other Depth to first ground water table _ 4. Is facility within boundaries of a city /town or sanitation district ? 5. Distance to nearest sewer system: e. ,� — Have you attempted to arrange a connection with the system? If rejected, what was the reason ?_ 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 - _ i( .?cj L1± (C 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: oz-- PV 8u c- HOL7E1 D Ep r - -- — /d _____42 Cft noCat ehot t ; -- • Date Signature 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 dan e! of pcilution of waters of the State may occur (Art. 66- 28 -8(5), CRS) and /or areas in w:.ich then; is no local septic tank ordinance. ' PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY ON THIS SHEET OF PAPER - pc (/GA( Dl dii/Olf? Tell cr L 9.570 ,gcFE, .c/-E ,c y,r/ "pen, , fl Q f( Nato © 22 Ypw Pot�W/ t° f r flot4' p rn " R ' p P l ii vg P � I i, girt). i VE i • Vo v 9 ' 1 f A� 4/11 h Q „4„, ‘ ,40i y P J G 4;7fi r� 1� 7 D 1Z tc 1% • ,San: 7 (8- 53 -50) COLORADO STATE DEPARTMENT OF PUBLIC HEALTH DIVISION OF SANITATION Code Section r ACTIVITY REPORT Count O FILE REFERENCE: ,, /D /// /Qf//fl . aliee0/96G .T.% /" Gins ?c_ INDIVIDUAL OR 'ESTABLISHMENT: 2).f . 7erjJ.4rVna i ADDRESS: raatr " , " g men VA/ .tc, &5 - l Otrn'WG[>Gai1D e300.0S, NARRATIVE: .D ae • A' /ZevAj e � .f r/ .n era e'€ arm en rs 0c yaps .c 679CW»v G "nee ern i A/ 4)/ ce* .,9 -VE-t2 •s-st a.f'o'w m t 7 " - rte elc.)c es O- 'n,! -c.. sJ in2CG2.c.I'err 04 -E 711 'rrt. 4S.e, sC N ne tis9cJC , fl oneX i m art :✓ 7So / ev- ft-r /9z- -- ✓s,'1o.e r a 5/ /doe /. re—e—)O r-/ P2 E .c ,9-7r2 -r e_.S . Dew w fl colt. 70 fll'E eX / 77 .0C, 1 oe , cva L e6/ C yews rl!/A/ / flt , f-7 /z L 0 tali //c !Jac, /7 Art/ t' C1 t/ ECSnO.C). — t / !Jr -, f-"" /9- /rte NOT cr,ad a/ L PC rTT©,c/ O/c rife n? e n0 6700-7 toe . F eten- G GD2 ~ r" ' ,c//v4-es, /.use�' 6t'' -Ge LETTER TO FOLLOW: () OTHER RECOMMENDATIONS: DATE: 9• 9 , 19 REPRESENTATIVE: /EP ��l�