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HomeMy WebLinkAbout00203 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 PERMIT # S 203 (this does not constitute ALTERATION NO FEE /CHARGE a building or use permit) Owner Knnrtnth A. Psh¢t System Location Min 117 Rnad .. rarhnneisl0 Licensed Contractor owner * Conditional Construction approval is hereby granted for a 11 /A gallon N/A Septic Tank or N/A Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Pere rate tl /A inches in N/A minutes N/A sq. ft. absorption area per bedroom ti/A k of bedrooms N/A x N/A sq. ft. minimum requirement May we suggest extending 4" sewer line from the workshop to the existing sintie e y st, , serving the residence to accommodate the sink for the worl..shni.. Date Aupu*t fl, 12E5 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 66.44.4, CRS 1963, amended 66.3.14, 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 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 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. �� _ e INDIVIDUAL DISPOSAL SYSTEMS APPLICATION Bldg. Official Appvl. (Building Zoning SB -35) Fees Paid Sony= NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE* INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ** Owner: [U-1..414,E, j'd \ Mail Address: t� fllu) City: Cn2ip: f&2 \ Phone: 7 '3 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 R_ City or Town �.0}(?,(?rAfa44.1(_ Legal Description OUnS I l`RLim Lot Size II -BS Ofxa c.„ 2. No. of Bedrooms Septic Tank Capacity Aeration Unit Capacity 3. Source of Domestic Water: Public (name): Private: Well p/ Depth 3')j Other Depth to first ground water table 4. Is facility within boundaries of a city /town or sanitation district? Y.10 5. Distance to nearest sewer system: 3 .00.1. alb II - A M 13 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 minut per inch of drop in water level after holes have been soaked for 24 hours: 13 A - 7. Name, address, and telephone of person who made soil absorption to ts: 8. Name, address, and telephone of person responsible for design of the system: 1 3 / 14- 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. -Py ate NOS g I 9 nature o f i / ner