HomeMy WebLinkAbout00204 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT # S N04 (this does not constitute
a building or use permit)
Owner Rowcz - r - l (C.t)Dit.
System Location lox $' 1■10. L. , t.. elesos L. 4'0 e ^^~, t r `')C n .
Licensed Contractor Low 1 J c
* Conditional Construction approval is hereby granted for a 7A"7 gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rats / inches in AS' minutes f,9'/2 sq. ft.
absorption area per bedroom sJ r)
# of bedrooms 2t x /fa ft. minimum requirement M. Ac- l ; -
May we suggest /ca .l 3c .1 ^3�' 'x mss r w . 4
Date % /S Inspector 4
r
iiC' FINAL APPROVAL OF SYSTEM:
li.
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 1968, amended 66.8.14, CRS 1988.
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 III, 8,24 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 cons
both. pp permit Petty (
tamed in the application of ermit commits a Class I, Pett Offense 8500.00 fine - 6 months in jail or
(Bldg. Official Appvl
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION (Building Zoning SB-35)
Fees Paid $7&
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: /C
Mail Address: /C ; ("em •)(S/Z'C CitY: Zip: vi go Phone: 4.'f/7
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 ( - /,` City or Town .'g:/fs rJ <V. %T // /i,{e
?MT of r..cT 4 set .5 MI $b, i11rv;'T/
Legal Description - Pi lot 90.1.9 C, htWPnl Lot Size ,rr--�+—
2. No. of Bedrooms .2, Septic Tank Capacity jr,007 Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well x Depth /et) Other — Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? Air
5. Distance to nearest sewer system: 4 //'/r S
Have you attempted to arrange a connection with the system? /L�l
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: c=7 - c7c._re_A,u,t1
7. Name, address, and telephone of person who made soil absorption tests:
S ST= �c — tt 1A 1 1 1
8. Name, address, and telephone of person responsible for design of the system:
c -C12 -W ( T
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.
0 7 / 7, 2, ; -
Date ign•ture o 1 ner
I
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY ON THIS SHEET OF PAPER -
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