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HomeMy WebLinkAbout00291 This does not constitute a building or use permit. GARFIELD COUNTY DEPARTMENT OF EP$VIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 REPAIR - NO CHARGE INDIVIDUAL SEWAGE DISPOSAL PERMIT Ned 291 Owner Ronald R. Johnson • System Location Route 1 - Box 57 - Lot 9, Asgard 11 - Silt Mesa Licensed Contractor _Q-L97 1J L"'{2 • • Conditional Construction approval is hereby granted for a . 1 gallon ex/ G¢7" /^/b X Septic Tank or Aerated treatment unit. Absorption area (or diapersal area) computed as follows: Perc rate of one inch in Iti/f]' minutes requires a minimum of A/ 9- sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms a x N/1 ft. minimum requirement = a total of 44/0 ft. of absorption area. CeA isrn.■b) May we suggest Lr9-G,iiv /3d b O4ovr �'O/7! SCT c 777fVf '._ '7't:? /7- � Ci AI L 7'7C rnr -rt•r7 r9 .9- e P T /O/v C ati - pri G- r-a/ Date �l ctor II FINAL APPROVAL OF SYSTEM: a CE C Qs c f 4 /4' t W10. ©WCE Pcr- '�f .5 7?/' C No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved rior to cover- . ing any part. ©k-- Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. "e Mr( IS €23re,_ Proper materials and assembly. 'N Inc Trade name of jeptic tank or aerated treatment unit. tCC._ Adequate absorption (or dispersal) area. MC-- Adequate compliance with permit requirements. Adequate compliance with County and State regulations /requirements. Other Date I Z ^- 13 l q c=. Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE "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 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 I11, 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 Paid $ u /C� INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date 1Q -IS D NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE cRE P 10(2- INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM Owner: k /L6/4 Mail Address A. / 3 7 City: 4 Zip: / 2,572 Phone: c7H 2 11e INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEWW 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 64QFiar> City or Town ,5>e, T / a flc' Legal Description 4/- `7 /1 SL;AxPD Lot Size « / 2. No. of Bedrooms S Septic Tank Capacity 44/4W t- Aeration Unit Capacity /cn.*ax,,. 3. Source of Domestic Water: Public (name): Private: Well t/ Depth /h'S Other Depth to first ground water table 4. Is facility within boundaries of a city /town or sanitation district? 72u 5. Distance to nearest sewer system: N/ Have you attempted to arrange a connection with the system? 4/fr If rejected, what was the reason? 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: N/ 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: (t,iLtio„-r✓ `_ -�U>� /2 nil 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 Signatur of Applicant (TO BE RETURNED TO HEALTH DEPT.) c- .---- - - -__— PLFOSFDBAW_AN.A000R___ ATE-MAP TO YOUR PROPERTY • N , G 0 m_1 IJa' v Sr / 1 i 6,-L.--i , c__ 11 SA P l fiti gr 60 0 r2 :1,-,4e1 ∎ y IX fil att fri 0 it pe INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES (TO BE RETURNED TO HEALTH DEPT.) Z � (� � �- 7 . 9-64-a Fret) -- CVO � c=�'t- � SEPTIC s V sT� LeD tT? e-C ((J 'rte I - 94) reakr,J 0 t & (t o f S . - OsoPy Fr 6t cs Fi9 2 vu-vserc =n-t tits ut 5 �� I a -s3. ? L p 0 c STOP WORK ORDER - INSPECTOR'S PORTION /-SST ,rJa rJc= DATE PERMIT NO.