HomeMy WebLinkAbout00227 ' 4
r , • GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH •
41. � 20I41EIake Avenue a
Glenwood Springs, Colorado 81601
I
PERC ONLY REPAIR PERMIT S 227 (this does not constitute
- - ---- 11 a building or use permit)
Owner Ina F Eilna
t ', System Location SS Highway 133 & Civil eKLake Road - Carbondale ,, ',
Licensed Contractor owner
* Conditional Construction approval is hereby granted for a iSOOgallon
. ( Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in minutes S " sq. ft. .*
absorption area per bedroom •i .(4*'e
0 of bedrooms .S /'+ S x sq. ft. minimum requirement " C7 ree 41-106 77 '
May we suggest .t / ,3 i 7 i'/ T � trV,G..'
/rV n7 /A,O/ Cr e ( ,',:. " "el i.
Date /'/ -- --' 62- z S Inspector i` 1
III
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
II
ill is approved prior to covering any part.
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DI e Septic Tank cleanout to within 12" of final grad rand 4,c es Dons abo a� grade.
c, '. Proper' materials and assembly. r flt/.t /- C1.'57 , / i !rt.) ,
ib row' Adequate absorption (or dispersal) area.
Iop `s ~~ Ade a com liance with ermit re uirements. '
goat P P q
r.` .. Adequate compliance with County and State regulations /requirements.
Date y .- / /-• 27,
` Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
1 "' *CONDITIONS:
1, 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.444, CRS 1968, amended 88•8•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.
111054 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 con•
I tained in the application of permit commits a Klass I, Petty Offense (5500.00 fine • 6 months in jail or
1 both. ��
Bldg. Appvl.
(Building ing Zoning 8 -35)
I INDIVIDUAL DISPOSAL SYSTEMS APPLICATION
Fees Paid $SV---
• NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
•
Owner: 9 ALA
Mail Address: ( - 2 J/0 City: caSZt Zip: Phone: 953 '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 a City or Town o,_• ___ _
Legal Description 47,t ¢ r .t Lot Size 2 , lTrc,"_
2. No. of Bedrooms 5 Septic Tank Capacity Aeration Unit Capacity
3. Source of Domestic Water: Public (name): L
Private: Well Depth Other Depth to first ground water table , 7
4. Is facility within boundaries of a city /town or sanitation district? -'t
5. Distance to nearest sewer system: 2 ..?flc-
Have you attempted to arrange a connection with the system? �ep—
If rejected, what was the reason? e -r
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: 2,41 7 77 ,{u
7. Name, address, and telephone of person who made soil absorption tests:
8. Name, address, and telephone of person responsible for design of the system:
%cc PE204 iT
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.
Date igna ure o Owner
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. OFFICE COPY
' . DATE Of.OP CEt A SHII ►ED CUfTON ER ORDER NO � SHIP VIA'
'4.0/2/ / J / � M l / �76 t
?y SHIP TO
GLENWOOD
���� -1 SUPPLY COMPANY
a SOLO To P.O. BOX 988
2802 STATE HIGHWAY 82 a PHONE 945.6488
GLENWOOD SPRINGS, COLORADO 81801
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UNIT D E S C R I P T 1 O N' P tt UNIT PRICE AMOUNT
loe S1A W 44,9 '
V 4 7 4 " 1 SZ N A. 111:2111111M1 7a /
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PLEASE PAY
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S ( / • -TT T AL CODE' STATE ALES TAX COOS. CITY SALES TAX FREIGHT INVOICE TOTAL NVOICE NUMBER
a /r i I( � �."' . ��
I. / ��_ THIS AMOUNT 'A 1 1 / - 7
A late mein FINANCE CHARGE on the unpaid balance of your account
(ANNUA RATE of 1896) will be charged if payment is cantina R E C E 1 V E D B Y
altar the tenth of 1 th. the month following purchase. In the *vent that this account
becomes delinquent and it is necessary to make collection through the courts,
the purchaser agrees to pay all collection costs, including reasonable ott y
fees and court costs.
Claims for adjustment must he made within 30 days from tha doto of the Invoice.
WI SINCERELY THANK YOU AND A IATE TOUR BUSINESS
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