HomeMy WebLinkAbout00396 This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
r PSRC FEE WArVDD — RATE KNOWN — FEE ONLY �
INDIVIDUAL SEWAGE DISPOSAL PERMIT N;' 396
Owner Mr. B Mrs, Ken Rush
vi System Location Lot 18, Filing 2, Westbank
ill Licensed Contractor John Rushing"
* Conditional Construction approval is hereby granted for 1 gallon
Septic Tank or X Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in $ minutes requires a minimum of 225 sq. ft. of absorption area per bedroom.
Therefore the no of bedrooms 3 x 125 sq. ft. minimum requirement = a total of 375 sq. ft of absorption area. „�•
May
Date we suggeshP Delp27ts29970, Square and l2' S pector __f ,.r' ..'''
R4NOTSt This system reviewed by Scarrow & Walker staff on Pe mit 11336 — this sys em is
FINAL APPROVAL OF SYSTEM: identical to that system. tt..ap . csv --a —
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 �y #) D(C
BLectc e. L,grp uP.
�
0 ,� ' TC Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
r a ` - -'" ( Proper materials and assembly.
4 9/.0 Trade name of septic tank or 67ated treatment unit -
tlC Adequate absorption (or dispersal) area.
e W,
/C Adequate compliance with permit requirements.
/U/C Adequate compliance with County and State regulations /requirements.
Other
/J // q �
Date tA' ( /97 Inspector 7�/2-r el
'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 11I, 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.
a.�............�.....�
Building Official Yoe =Yit White Copy Applicant — Green Copy ___ Dept-- Pink Copy �Y�--
% Fees Paid $
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION
Date —77
„ ' NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE f
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: /h R ma 14E A) (4u s N (So .o Wit 8,&664- Col,'r2
Mail Address: P. &ox 9.8.7 City: (,../e wnop Zip: V /Doi Phone: 995ef -66/9
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW
Attach separate sheets or report showing 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 GARFreco City or Town t Egr800c..
Legal Description Corr (8 F Lr 4DG $11"-- Lot 20 o 'c 20 c,
2. No. of Bedrooms 3_ Septic Tank Capacity (2-1 Aeration Unit Capacity / a r
4 0
3. Source of Domestic Water: Public (name): (.064,7-43,1A/a..
Private: Well ,/ Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? NO
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system? No
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in min es pe inch of
drop in water level after holes have been soaked for 24 hours: p • /
7. Name, address, and telephone of person who made soil absorption to ts:
8. Name, address, and telephone of person responsible for design of a sy em:
9. Express permission is hereby granted for the inspection of the above p .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.
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.
(.1--g. 7— 77 � .z(/.. u 4
Date Signature of A9i nt
(TO BE RETURNED TO HEALTH DEPT.)