HomeMy WebLinkAbout00260 ii, 4
I lii i This does not constitute
a building or use permit.
GARFIELD COUNY DEPARTMENT OF ENVIRONMENTAL HEALTH
It 2014 Blake Avenue
IIt Glenwood Springs, Colorado 81601
„ti
kigh INDIVIDUAL SEWAGE DISPOSAL PERMIT N? 260
In
O Valley Farms Inc.
;I Owner ,
ki System Location 2 miles from Silt 1
Wh' Licensed Contractor owner a ,
�f
ry
I
* Conditional Construction approval is hereby granted fora 7c » 0 gallon
iii X Septic Tank or Aerated treatment unit.
il Absorption area (or diapersal area) computed as follows:
N, PIc rate of one inch in ,3inutes requires a minimum of sq. ft. of absorption area per bedroom.
ti ii
i" Therefore the no. of bedrooms a x •akesq. ft. minimum requirement = a total of 6re0sq. ft. of absorption area.
ir
May we suggest /a.'X S "y x a / to i i"
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Date /— %,3" 2b Inspector ��
iii FINAL APPROVAL OF SYSTEM:
ii
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover-
,
ing any part.
dle-- Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
' Proper materials and assembly.
.'d ete..----"--
Trade name of septic tank or aerated treatment unit. 75C? CorseiZ . Qpi�EG/f',G/, s jO .-%
a
iC/ - ' Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
. Adequate compliance with County and State regulations /requirements.
Other
Date ! 7 - 7 Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
ii *CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority 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 requirernents.
Connection to or use with any dwelling or structures not approved by the building and Zoning office shall automatically be a viola-
tion 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 disposaj system in a manner which in-
volves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class I,
Petty Offense ($500.00 fine — 6 months in jail or both.
Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
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Fees Paid $7S-.°1)
t " INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
t
Date ZI -10_1(
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: 1/n L t r t o s fl
Mail Address: Bog '148 City: S T— Zip: b /67S2 Phone:976
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 6 4R F c f t p City or Town Si c. r
Legal Description t Si.ie Sp p o Vic.
eF
2. No. of Bedrooms 2 7
Septic Tank Capacity /p -- 0 Aerat
ion Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well ,( Depth Other Depth to first ground water table ?
4. Is facility within boundaries of a city /town or sanitation district? ,v
c 3
5. Distance to nearest sewer system: 3 "22/
Have you attempted to arrange a connection with the system? 'f��
If rejected, what was the reason? 7 / &o �CC9
6. Rate of absorption in test holes shown on the location map, in minptes per inch of ��
drop in water level after holes have been soaked for 24 hours: ,// ��V
7. Name, address, and telephone of person who made soil absorption s: ts:
/ 7
O
8. Name, address, and telephone of person responsible for design of a system:
9. Express permission is hereby granted for the inspection of the above pf4perty
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 Sr naa of Owner
(TO BE RETURNED TO HEALTH DEPT.)