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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL. HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
II
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PERMIT 0 S 0+ (this does not constitute .
a building or use permit)
Owner DWI Karat id
" System Location Road 113 — Cattle Creek Road 3 miles
Licensed Contractor
* Conditional Construction approval is hereby granted for a,s gallon ,•afivnaoar�°>
+ I ,
hi
_ ' Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as folio" s:
Pere rate / inches in /4a minutes / sq. ft.
err absorption area per bedroom 7712? 't
N of bedrooms, 3 x ; sq. ft. minimum requirement -. . . 2 r s
May we suggest /a )e. A/f zit ,' .MSr� c . r
Date /'eQ —,,,,,F 7,,C Inspector ,� .1 :' w
FINAL APPROVAL OF SYSTEM:
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No system shall be deemed to be-in compliance with the Sewage Disposal Laws until the assembled system m
is approved prior to covering any part.
6tZ Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
'asp .g evinG 771Wi4C—
0 ---- . Proper materials and assembly. �N
.0-e- Adequate absorption (or dispersal) area.
` Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements,
Date 3 - - 7y, Inspector ije`"
ii RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
. A
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuknt to authority granted in 66.44.4, CRS 1963, amended 66.8.14, CRS 1968.
2. This permit ie,valid only for connection to structures which have fully complied with County Zoning and
building requirements. Connection to or use With an$ 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 II1, 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- r
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or
both. ____
Bldg. Official Appvl/ pi
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION (Building Zoning SS-
,A)
Fees Paid $ ?
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
�/ INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: OA-/J 11 E R 5
Mail Address: 12,03 Colo 4v 4. City: I UGiunia ,rip: X /60 S =
/ Phone: 9V5'935
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW p
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
14qA41 i L. City or Town Legal Description ai9ueheJ Lot Size 712 6 acre- 5
2. No. of Bedrooms .3 Septic Tank Capacity ISOOg Aeration Unit Capacity
3. Source of Domestic Water: Public (name): Go � � JJ
Private: Well Depth Otherip4 Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system: /0 - -kco
Have you attempted to arrange a connection with the system? -),,,,
If rejected, what was the reason? - y,,o¢ arp 4T26fe
6. Rate of absorption in test holes shown on thi location map, in minutes per inch of
drop in water level after holes have been soaked for 24 hours: e -- z X -71,✓
7. Name, address, and telephone of person who made soil absorption tests:
Q / _ /
8. Name, address, and telephone of person responsible for design of the system:
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.
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