HomeMy WebLinkAbout00248 •
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
•
(this does not constitute
PERMIT b S a building or use permit)
Owner Norm <an L. and Hazel'.: Herwick
System Location Si 1 t Mesa
Licensed Contractor 6,- ,-/An- ,'
* Conditional Construction approval is hereby granted for a i nf(i gallon
Septic .Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in ``? minutes /7) sq. ft.
absorption area per bedroom ' y.c'( -? "
•
. - L
�. . S / e- ...y`t r. ... / r :
11 of bedrooms 3 x ; /9e sq. ft. minimum requirement- / r ,
it ,'1-
May we suggest /,> �X 4; .. r ( .5 c t..� f�,`" l A
J
f
a - asS
Date 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:
CPC— Septic Tank cleanout to within 12" of final grade or aerated access ports above ade.
/ s CO G. mt.. <.�c � zrfre. c.e22
C— Proper materials and assembly.
'• Adequate absorption (or dispersal) area.
tre Adequate compliance with permit requirements.
aLAdequate compliance with County and State regulations /requirements.
Date — 7,7 Inspector
QQ n.v
RETAIN WITH RECEIPT RECORDS AT CO S' (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 111, 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-
tained in the application of permit commits a Class I, Petty Offense (5500.00 fine • 6 months in jail or
both.
Fees Paid $15,
' INDIVIDUAL DISPOSAL SYSTEMS APPLICATION
• • Date c7-1q-7(o
• NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: /14ill7'4'1, /./ze/. r /Zen /C .
Mail Address : ,coy /7/ Ci ty: ��. Zip: 776,10. Phone:; a/
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 6Zz9rie /r/. Ci or Town , e.' •
t. SW* NEB SE# „fec tb
Legal Description T,s s -3 1 ,P9, rh . Lot Size rya ;r � S % Kg: /.5 f�
2. No. of Bedrooms , 3 Septic Tank Capacity /G.757" fee .Aeration Unit Capacity
3. Source of Domestic Water: Public (name):T,e;r,4,
Private: Well ✓ Depth X' Other Depth to first ground water table ,?f /
4. Is facility within boundaries of a city /town or sanitation district? y°
5. Distance to nearest sewer system: . 5 i// -3 A7_-4S
Have you attempted to arrange a connection with the system? ',p
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in min es per inch of
drop in water level after holes have been soaked for 24 hours:
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 s stem:
at
9. Express permission is hereby granted for the inspection of the above pro erty 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.
rt /� iii.
Date ,,. atur "t er
•
(TO BE RETURNED TO HEALTH DEPT.)
. .
/1 , PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
' 4
• • --- ---- _
•
i I a f etTliet° 1 1
. ,;-- e;;;
.
.
ant ad.
( 7/79.----
--i\
^-■ . qA/
ti
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES STREAMS, IRRIGATION DITCHES ROADWAYS AND BOUNDARY LINES
Y. 1
ilk ifrey r-'
t' e ref/
i .
7,-..
1
,,
1-) P d,/c4 . 1
..-7 4-,4 N o P., e s Le J
0 filltg--<
0 Jot) •
— - i ,, • rwAsCvey - i "
(r i
_ 4,90,_____,
% .
i it A
/1\ ? ! ty
• 12. rii '44s
k I! 1 ‘1 '11 7 4?regaoPev: eat g
`)4 c--
li
41 .*
„ress . .
(TO BE RETURNED TO HEALTH DEPT.)
_ .