HomeMy WebLinkAbout00448 4 ry L� Id.
This does not constitute
a building or use permit.
•
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014.BIake Avenue
4f rin s ,
Glenwood S g Colorado 81601
fl
PSRC FRS WAIVED - RATS KNOWN - FIR (WLY
INOIVIDUAL SEWAGE DISPOSAL PERMIT Nti 448
Owner Leonard J. Rosner
System Location §Qt #5, Filing Si, Wortbank
a04-16. C fr- (e -c-i p
Licensed Contractor
Conditional Construction approval is hereby granted fora If 250 gallon
Septic Tank or X Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in 5 minutes requires a minin)um of 225 sq. ft of absorption area per bedroom.
Therefore the no of bedrooms 4 x 225 sq. ft requirement = a total of 500 sq. ft. of absorption area
May we suggest Deep Field 12' square and 12' deep
Date August 22 , 1977 Inspector /
eiiT r This system reviewed by Scarrow & Walker /KKBNA Staff on P • # - t hi ystem
FINAL APPROVAL OF SYSTEM: is identical ;to that system with addition of 2 be � ' p dr . —
No system shall be deemed to be in compliance with the Sewage Disposal Laws until th bled s is approved p to cover-
ing any p2.
Septic Tank cleanout to within 12" of final grade oTBZPSted acceirribttrebOV�iiF Zie.
�Jry
Proper materials and assembly.
Trade name of septic tank or aerated treatment unit.
Adequate absorption (or dispersal) area
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
r / Dthgr .) �? �, „/
II Date Inspector
•
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 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 terms 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 Copy Dept. — Pink Copy
L auv '. .
Fees Paid $,,\
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION Date - Z �7
`
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE c2e umior
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: h Pdharo( d/ R C1S/1er •
c�
Mail Address: 409142 lf/esf%h..� C,4ucte Zi
' it ( s p: ev40/ Phone: ?V >606
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 larT'jeld City or Town (->%4ak)Oa/ civiSty.1
Legal Description 24 C / / � Lot Size / Q 2- -dote_
2. No. of Bedrooms 7 Sej Tank Capacity /� SO Aeration Unit Capacity
ce mew :SAC (name): Ghd40 j C e t ( s7 cjn
3. Source of Domestic Cr: e Pu lic name U ,
Private: Well )( Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? A/4 c
5. Distance to nearest sewer system: 7' )27/45
Have you attempted to arrange a connection with the system?
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: �7
J ec Pc /7'
8. Name, address, and telephone of person responsible for design of the system:
S «- , c7»p / 7
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.
/ /12/ 2-- „ /
Si.
Si. -..� a .f Applicant
cant I i
(TO BE RETURNED TO HEALTH DEPT.)