HomeMy WebLinkAbout00201 �,
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�/ � � GARFEL COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH ,
2014 Blake Avenue
Glenwood Springs, Colorado 81601 ! ' k !;; c
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PERMIT N S 201 (this does not const ,
a building or use permit) � 4 '
Owner ()avid l Vnstorbv
System Location 4. fast 1/2. Lot 13, Sec, 18, R. 87 W., T. 7 5. - Carbondale
Licensed Contractor ti % A"' -
* Conditional Construction approval is hereby granted for a gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate inches in minutes sq. ft.
absorption area per bedroom
it of bedrooms x sq. ft. minimum requirement
May we suggest
Date ' Inspector
FINAL APPROVAL OF SYSTEM:
4 + ' No system shall be deemed to be i(t ■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 matpgals and assembly.
Adequate"absorption (or dispersal) area.
Ade'ate compliance with permit requirements.
.Actequate compliance with County and State regulations /requirements.
Date Inspector
..r' 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 88.44'4, CRS 1983, amended 66.3 -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.
8. Section 11I, 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-
mined in the application of permit commits a Class I, Petty Offense (8500.00 fine - 6 months in jail or
both.
Bldg. Official Appvl.
p.� + (Building Zoning SB -3b)
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION
Fees Paid $7S
=
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: !J/74/° A. !/�srr - 4/al-
Mail Address: y / Jo P , City: c c/s,A'ogt. Zip: P /ca3 Phone: Qc - .7/7o
INFORMATION REGARDING PROJECT SUBMITTED 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 percola-
tion test holes, soil profiles in test holes.
1. Location of facility: County 6,0,1,c City or Town f,4,vsova40,44.
Legal Description 'fr„ ion; su is,IA,wr;r Lot Size 23 _l - es
2. No. of Bedrooms 4/ Septic Tank Capacity /A so Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well X Depth Other Depth to first ground water table ,3o
4. Is facility within boundaries of a city /town or sanitation district? N
5. Distance to nearest sewer system: 600 P,7 /■♦ / v —7 S r
Have you attempted to arrange a connection with the system? /1/2).
If rejected, what was the reason? /J,
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: ,c E _, 6r7e,. L! T
7. Name, address, and telephone of person who made soil absorption tests:
.Sc? $ 972#kf
8. Name, address, and telephone of person responsible for design of the system:
„5E 4=arT
9. Express permission is hereby granted for the inspection of the above property by any
member of the Garfield County Environmental Health Department and /or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Environmental Health Department.
10. I have been given an opportunity to read the Individual Disposal Systems Regulations of
Garfield County and I hereby agree to comply with all terms, conditions and requirements
included therein.
42 Die '7-� /
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�• PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY ON THIS SHEET OF PAPER -
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