HomeMy WebLinkAbout00427 F ir y 4 411, l!'11411111 d ,q r 7 I I j l■ 1? ^;. T _ „` `: . B
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10,1 a building or use permit. N
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
207 Blake Avenue ,. I'
Glenwood rings, Colorado 61601 V .,=III]
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INDIVIDUAL SEWAGE OISPOSAI. PER ��► � 427 T
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Owner Dminis L..StOSr+7 .rsjtoiw�r� 4 I '
System Location Lot 12 — New Castles — SIk dank Subdivision 1 ili '.
Licensed Contractor OMnet ” -
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ii II ' Conditional Construction a prq'yal is hereby granted for • / 00 gallon I it ,ll
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Septic Tank og� Aerated treatment hit. i . -
Absorption area (or diapers& area) computed as follows: �. yy " -
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Pere rate of one ineh in - ✓Q minutes requires a minimum of ��,1 —sq. ft. of absorption area per bedroom. { -
Therefore the no. of bedrooms -3 x 7 14...C. $9. ft' minimum requirement = a total of #19.45 ft. of absorption ante. '
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May wesuggest �ee F'A�r e� edit -2 1 X ,3 1 ,1) e �C(IdN /NCB AST Wei A r
Date -ex TXC d /9 , Inspectors -4!!a..„+• ieciasIM �
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FINAL APPRO AL OF YSTEMr .. .' is w • . — ,a '
No system shall be deemed to be in compliance With t Sewage Dispose' Laws until the assembled system is approved prior to cover
ing any Part:
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Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.i
IIli Proper materials and assembly.
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I�I�'i; C- 39 - --- Trade name of septic tank or aerated treptment unit. /4'zo =r�.c rt - » C . J.
ji Adequate absorption (or dispersal)erea. . ' k.
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Ade uate com liance it permit requirements.
with
III G` Adequate compliance with County and State regulations /requirements. III ,
ii Other yV) / Jc , c 2 -yr " D /° et-rf °Odra -/ c 9.
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Date F — "7.- '5' - 7 7 Al* Inspector ,i i — f �.
II RET WITH RECEIPT RECORD AT CONSTRUCTION SITE
Ilf "CONDITIONS:
1. All installation must comply with all requirements of a County IntJividual Sewage Disposal Regulations, adopted pursuant to au• il o
thority granted'In 66.44.4, CRS 1963, amended 66.3 -1 , CRS 1963.
2. This permit is valid only for connection to structures Which have fully complied with County Zoning and building requirements. r IiI
Connection to or use with any dwelling or structures not approved by the building and Zoning office shall automatically be a viola. 4F,
tion of a requirement of the permit and cause for both legal action end revocation of the permit.
3. Section III, 124 requires any person who constructs, liters, or installs an individual sewage disposal system in a manner which In
VI volves a knowing and material,wariation from the terms or specifications contained in the application of permit commits ;e Class I, II
Petty Offense ($500.00 fine — 6 months in jail or both. :
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'li Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
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Fees Paid $ 75�
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION (0-D.;),:/-)
Date
4 / . , NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
n INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: 1 e n n i f 1 . 8/ loin / •
Mail Address: p 75 Z City: Afu..,f f Zip: B-746/ Phone: gy5-53S/
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 , ,,,471 ,;, / City or Town /l7, k.' ��,,7 //!
Legal Description 0 4 /2— Lot Size /gee
2. No. of Bedrooms 9 Septic Tank Capacity Aeration Unit Capacity
3. Source of Domestic Water: Public (name): ,' (!(, o /t W n7yr)24 „.? 4,
' Private: Well Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /Lc
5. Distance to nearest sewer system: 7 Age j
Have you attempted to arrange a connection with the system? ///b
If rejected, what was the reason? ,vo
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: Mar "sr 1
7. Name, address, and telephone of person who made soil absorption tests:
_fir / 7 / T
8. Name, address, and telephone of person responsible for design of the system:
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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.
oft Z/72
Date Signature o Applicant
(TO BE RETURNED TO HEALTH DEPT.)
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PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WAT U PPLY A ND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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(TO BE RETU " ED TO HEALTH DEPT.)