HomeMy WebLinkAbout00146 • r
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL. HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT # S 146 (this does not constitute
a91l a building or use permit)
Owner Estate of Raymond NNK Hopkins - Kathleen Peckham. Executor
System Location Lot 3. Section 28. Range 88 West. Townshia 6 South
Licensed Contractor owner 7S0
* Conditional Construction approval is hereby granted for a4er gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in ..?o minutes c' /!.7 sq. ft.
absorption area per bedroom ra..J /9
# of bedrooms Z x oz/e) sq. ft. minimum requirement m -'/a- 54. F cam/ " ��sr�Pf'7' /larlf
May we suggest /n2 / X 3S'X ES 1)
✓
Date �_> -- 7 S 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.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
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 66.444, CRS 1983, 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 'Sri any dwelling or structures not approved by the building
and Zoning office shall automatically be a vielatIon of a requirement of the permit and cause for both
legal action and revocation of the permit. H
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 from the terms or specifications con.
twined in the application of permit commits a Class I, Petty Offense ($500.00 fine • 8 months in jail or
both.
T. C0L8RAD0 DEPARTMENT OF HEALTH
! Water Pollution Control Division
4210 East Ilth Avenue .
Denver, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL , HOOME SEWAGE TREATMENT SYSTEM **
Owner: Grfrarc. ee i9c.I9Cri/.fi/ 604'/5
Mall Address: y3t8 & /IS Cit Zip 8&4/ Phone gtre S37o
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: mss m VW 5:2
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography or area, habitable buildings, location of potable water wells,
soil percolation test holes, soil profiles in test holes.
1. Location of facility: County 6 4.ef /£[D .City or town ,4zow $oormi5,
%uuna p G Sari.
Legal descriptioni 2.R F,avac Bern Lot size , 33o0AC4E6
/
2. No. of bedrooms f l a ) SeeF
ptic tank capacity '?,'O Aeration unit capacity
3. Source of domestic water: Public (name):
Sarfctte. Sprthc,
Private: Well Depth Other_x Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /14o
C 5. Distance to nearest sewer system: /!'9 / ( ?� `-,==
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 neap, in minutes per Inch
of drop in water level after holes have been soaked for 24 hours •
7. Name, address, and telephone of person who made soil absorption tests:__ —
S 9 a144,r / 7
8. Name, address, and telephone of person responsible for design of the system:
C g 54 a,UO %.56 11 us arw•(1oO4 .f g £t 8160/
___a ins- _ ? cti,,-w / b ! `� -,�-
Date Signature of Owner n«vnn,
* Required by Article 66- 28- 12(CRS, 1963, 1967 Perm. Surn. Supp.)
* *Required in areas which have been identified as areas in which dance! of pcllutrno
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.
•
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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:
Date Approval Disapproval
•
Signature for Local Health Department
tiFM
Signature for City /Town Official (Title)
Signature for County Official (Title
Comments:
Signature and Title
Note: The Notifier (front of this sheet) must obtain comments and sicnature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTH: DEPARTMENT USE: Recommendations of the District Engineer:
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
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h'Y- 33(lo -72 -2)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY ON THIS SHEET OF PAPER -
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