HomeMy WebLinkAbout00340 This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 340
Steven P. Szymanski
Owner
System Location 4775 •County Road 117 - Glenwood Springs, CO
Licensed Contractor
Conditional Construction approval is hereby granted for a cPcst' gallon
X
Septic Tank or Aerated treatment Unit.
Absorption area (or diapersal area) computed as follows: ,
Perc rate of one inch in 60 minutes requires a minimum of . sq. ft. of absorption area per bedroom.
' . Therefore the no of bedrooms • •R x -e ft minimum requirement = a total of 1y0 sq. ft of absorption area-
. May we suggest 440>' X d . ' 3 _: &W-7° `!' .... stk.-ft) �.
Date "' 'reP `�".^'' Inspector
- a ` FINAL APPROVAL OF SYSTEM: C` ^f ��
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover
Po ing any part.
- i`ri N Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
n■ii 4 , 1
u 1 1�s�y 'Pr oper mater and assembly.
II
- 711 rade name •f septic tank or aerated treatment unit.
+ �"V Adequate absorption (or dispersal) area
Adequate compliance with permit requirements-
„
m • �� Adequate compliance with County and State regulations /requirements.
Other
1P Date /7 Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
•
ir
'CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to ow
thority granted in 66444, 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. V M"
Connection to or use with any dwelling or structures not approved by the building and Zoning office shall automatically be a w914,•
Lion of a requirement of the permit and cause for both legal action and revocation of the permit. ro
3- Section III, 3.24 requires any perspn who constructs, alters, or installs an individual sewage disposal system in a manner which In
valves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class 1 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 $ __
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION
Date (o
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: 3 P. Szy&ANSiL\
Mail Address: a - 15 II"J 'Rd City: C SPPATh Not fm
S ?2�abs Zip: glbol Phone: Yea
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 Z.PI6- t City or Town
Legal Description 00 P ‘ - Lot Size )O Accts
2. No. of Bedrooms 9t Septic Tank Capacity }inx) Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Well ) Depth Other Depth to first ground water table 3SO
4. Is facility within boundaries of a city /town -sa ation district? NO
o Q it
5. Distance to nearest sewer system: el VL) k
Have you attempted to arrange a connection with the system? O L ���
If rejected -, what was the reason? '- ` yq-�c 4.17-7D-
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: _f= Z p c -Z
7. Name, address, and telephone of person who made soil absorption tests:
SLR Pc=t2.c ct T
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.
/0/51-np SEW-3/4 C Date Signature of 4 scant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
7200 pr
W "-
a RAP
Fr JI'W SE
®�
r
p0000stb
lc Ac R, s 7000 p-.
INDICATE BELOW T11E LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
}'ouse o &) P.4 L„ - r- cas -E2. of Pitabe 1-7
NO SneMM S o►J P RQPE -ry
Lor SLOPES Dowd t%aoM 6404 To ( -/ZONr
{+OUSE A-to t' WEB PANE SC. rtC. S ITE
(TO BE RETURNED TO HEALTH DEPT.)