HomeMy WebLinkAbout00405 4 This does not constitute
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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH a building permit.
2014 Blake Avenue
w, h WAIN — NO PBS — PERC ONLY Glenwood Springs, Colorado 81601
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 405
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1111 it , _
Owner J1
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9y system Location North o New Castle, Co2ora o
kul I 1 1 ' Licensed Contractor OuW -I i
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uu,^ * Conditional Construction approval is hereby granted for a �o.J 7 ° gallon
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Septic Tank or Aerated treatment unit.
Absorption area (or diapers& area) computed as follows:
P
ercr
rate of
one
mm
p -- minutes s re wires
a minimum nimum of ZGlsr
s .ft.
of
4 absorption area ea
per P bedroom.
Therefore the no of bedrooms x /.4,<__ sq ft minimum requirement = a total of {r60
sq. ft of absorption area
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May we suggest De W ez,,G /o �)C /O ' � �
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y /.d, leT
Date /9'
? Inspector _ - /✓
FINAL APPROVAL dF SYSTEM: l!ll—t
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover l
ing any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
ii `!`"" Proper materials and assembly. � ,
il a
_- . ^"'�d
1.4 e name ,r aerated treatment unit. 4 r;
44/C:"--- Adequate absorption (or dispersal) alli dequate compliance with permit requirements.
Ovate compliance li
p ante with County and State regulations /requirements.
Other
Date �j - - -z—`T „—,7>
Inspector �1 '�'
RETAIN WITH RECEIPT RECORDS AT CON 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, ORS 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 tern 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 Co
PY Dept. — Pink Copy
Fees Paid $ P
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date
, ; NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
•
Owner: /f/I ti r t u ( -- ! --t •
�'es toeL 24S assn
Mail Address:a
City: 11�.ew�'as`�� Zip: �/� � `� Pho ne: 9F�-14?
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 C�- t`itiy City or Town 440, 0 fit
Legal Description Iity Sec- ."'s 5 o t Lot Size / / ° a c r-e s
2. No. of Bedrooms ' Septic Tank Capacity Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well Depth Other c il Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? i1/0
5. Distance to nearest sewer system: =1
Have you attempted to arrange a connection with the system? 4f
If rejected, what was the reason?
5. 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.
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 Signet r of Ap. icant
(TO BE RETURNED TO HEALTH DEPT.) C/
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
ITION L ES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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(TO BE RETURNED TO HEALTH DEPT.)