HomeMy WebLinkAbout00269 y j This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
REPAIR - PERC ONLY
INDIVIDUAL SEWAGE DISPOSAL PERMIT N; 269
Owner Bob Gregory
System Location Peach Valley
Licensed Contractor B & B Tree Service & EXcavatlno
" Conditional Construction approval is hereby granted for a 7S0 gallon
X Septic Tank or Aerated treatment unit.
Absorption area (or diapersal area computed as follows:
I Pere rate of one inch in .f0 minutes requires a minimum of 1 "? S - sq. ft. of absorption area per bedroom.
II
Therefore the no. of bedrooms 4 " 2 x •aamIci. ft. minimum requirement = a total of Sn ° sq. ft. of absorption area.
May we suggest /..i / X y� / .. 3 r _06 t-"�./9TiC �c
Date 7�` � Inspector "
FINAL APPROVAL CiF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover -
l.. ing any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
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tJt (*e t— Cv -.cJ Q..¢9ec` -eisc -4a
Proper materials and assembly. //G /A/ P c rt --
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Trade name septic ta91k or aerated treatment unit. depOE'2 +Y7fdt
X -qrs' X 77
Adequate absorption (or dispersal) area. . 3 / Se� /.0•%.-T c
Adequate compliance with permit requirements.
G "" Adequate compliance with County and State regulations /requirements. •
Other
Date `! ' Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
0 "CONDITIONS:
li. 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au- -
t6ority 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'Giola-
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 disposal 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.
u - Building Official - Permit White Copy Applicant - Green Copy Dept. - Pink Copy ��_
Fees Paid $`2)
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION
Date t_�7 —`,
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE *�j
� �
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ** elTh- u
Owner: 1306 GR £g-oe Y .
Mail Address: jli4 Yp € /I City: 5/4-7 Zip: Phone: R'7/.,..W.57
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 GObef -c_p City or Town Sfc_T. (Petp (.%tcc>
Legal Description - - Lot Size ` iftR -g
2. No. of Bedrooms f t Septic Tank Capacity /000 Aeration 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? A/0
5. Distance to nearest sewer system: 1/41(c-es
Have you attempted to arrange a connection with the system? -7-z6
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in mi tes p r inch of (G:7
drop in water level after holes have been soaked for 24 hours:
7. Name, address, and telephone of person who made soil absorption to s:
8. Name, address, and telephone of person responsible for design of t system:
9. Express permission is hereby granted for the inspection of the above pr perty 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.
4-a -1 8oe Cle6 cotY
late flner
(TO BE RETURNED TO HEALTH DEPT.)
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