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HomeMy WebLinkAbout00334 oft, k ' - -•— This does not cons ute GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH a building or use • - rmit. 2014 Blake Avenue Glenwood Springs, Colorado 81601 INDIVIDUAL SEWAG DISPOSAL PERMIT �k' G�.Q.N„,.LA +-346 N' 334 aic c,i i.t., . - A,©:- E _ 6. -1 Owner Chuck Becker �� Lot A3, 3rd cling, Asgard Subdivision System Location r Licensed Contractor owner . Conditional Construction approval is he •b granted "- ,. Y g anted fora gallo ii g Septic Tank or Aerate. treatment unit. Absorption area (or diapersal areal computed as f. lows: Pere rate of one inch in minutes requires a , inimum of sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x sq. . mi um requirement = a total of May we suggest sq. ft. of absorption area. Date Spector FINAL APPROVAL OF SYSTEM: No any s pa pa rt shall be deemed to be in complia e with the Sewage Dispo .1 Laws until the assembled system is a o any approved prior to cover- --------- Septic Tank cleanou o within 12" of final grade or aerat :. access ports above grade. —_ Proper materials : d assembly.' Trade name o septic tank or aerated treatment unit. ---- -- Adequate .sorption (or dispersal) area. -- Adequ. e compliance with permit requirements. - --- Adequate compliance with County and State regulations /requirements. _____________ •. her Date Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION TE k * CONDITIONS 1. All insta ation must comply with all requirements of the County Individual Sewage Disposal Re! lations, adopted pursuant to au- thority !ranted 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 Zo 'n Connection to or use with any dwelling or structures not approved by the building and Zonin offi.> tion .f a requirement of the permit and cause for both legal Action and revocation of the permit, g and building requirements. 3, Sec on III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal • stem in a manner which in- 9 shall automatically be a viola - vo es a knowing and material variation from the terms or specifications contained in the application . f permit commits a Class I, Pe ty Offense ($500.00 fine — 6 months in jail or both. Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy Fees Paid $1S INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Datee- R -jam NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE -L INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM u c9).AL (9..,, . K ��st n Owner: ... _ v,c -,PyL/ 3 Mail Address: D ,2 G/: fc -/ City: /,L/ Zip: 7/4.67 Phone: P/_- 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 „ g j , � , � , , , g /. City or Town Legal Description �� 4A <,LLot Size C x• • , 2. No. of Bedrooms ___ Septic Tank Capacity )((p Aeration Unit Capacity - 3. Source of Domestic Water: Public (name): Private: Well X Depths Other Depth to first ground water table / .2 4. Is facility within boundaries of a city /town or sanitation district? 44; 5. Distance to nearest sewer system: Have you attempted to arrange a connection with the system? O16) 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: 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: 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. if late Signatu e o Applicant (TO BE RETURNED TO HEALTH DEPT.)