HomeMy WebLinkAbout00270 1 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
II ., INDIVIDUAL SEWAGE DISPOSAL PERMIT NV 270
Owner I arry Wilson
System Location S i l t
Licensed Contractor & & B Tree Service & Excavating
Conditional Construction approval is hereby granted for a 758 gallon
X Septic Tank or Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in a O minutes requires a minimum of 4 /O sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms _ea_ x a1/ sq. ft. minimum requirement = a total of sq. ft. of absorption area.
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wen) <.�. _ - ''� X AA/A-3/ e:c> i rTS � -
May we suggest 212k /N3�77yc c. a .'27 y ) � a,� .
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Date y a - 7 es. Inspector
es.4"-/r7F592 4' /edersva'v .40A- AzerGeq»no,
FINAL APPROVAL OF SYSTEM: e TO ,Spry „ty t g sp y ; ep e` c aza ,`/
77 Neu) • ./ fr e
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.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
� ' Proper materials and assembly. ®,
a Trade name of septic tank or aerated treatment unit. e Z �Z7 ) �1� 's%fv ,,.•�i�
s w2 - Adequate absorption (or dispersal) area. �q/S�f �
/j ��� /
/ " e /�/ Adequate compliance with permit requirements.
e /rte Adequate compliance with County and State regulations /requirements.
Other •
Date .,.,3 Inspector 04-e---s<1
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS: ,f
1. All installation must comply with all requirements of;�:�fhe County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 66 -44 -4, CRS 1963, amended 66-314, 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 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 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.
Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
-- -- -
Fees Paidff'
INDIVIDUAL DISPOSAL SYSTEMS APPLICATION Date /t< 7 -7�p
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: / fbCjY
Mail Address: 9gg7 31/ kb City: 5 /c. Zip: Phone: _______
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 67AIZ F,E City or Town St Cr.
Legal Description 4C Lot Size Q ARE S t —
2. No. of Bedrooms 2, Septic Tank Capacity /o-o) Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well X Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /LIo
5. Distance to nearest sewer system: /p en ig_j- S
Have you attempted to arrange a connection with the system?
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes pe inch of (=
drop in water level after holes have been soaked for 24 hours: �_0L( /
7. Name, address, and telephone of person who made soil absorption tests:
(T
8. Name, address, and telephone of person responsible for design of the system:
SZ cP-r
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.
! 0.77 7( G nicer 1 i s4nl
Date Signature of Owner
(TO BE RETURNED TO HEALTH DEPT.)