HomeMy WebLinkAbout00453 " •
1111 u This does not constitute I'
✓ .1 a building or use permit.
•
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
II: 2014 Blake Avenue
Il i: a Glenwood Springs, Colorado 81601
PERO FES WAIVs' - RATS KNOWN — its ONLY
' INDIVIDUAL SEWAGE DISPOSAL PERMIT N2 458
I illii
Owner Frederick a. Smith
l
II „. ,.,,;': System Location Lot 11', Filing XIIS, Westbank Ranch
IL Licensed Contractor int aC9y
1111 f Conditional Construction approval is hereby granted for a 1,00 gallon
i 1
Septic Tank or X Aerated treatment unit.
VIII: Absorption area (or diapersal area) computed as follows:
it Perc rate of one inch in 5 minutes requires a minimum of 125 sq. ft. of absorption area per bedroom.
Ipll Therefore the no. of bedrooms 3 x 125 sq. ft. minimum requirement = a total of. 375 sq. ft. of absorption area.
May we suggest Deep Field 10' Square and 12' Deep,
hi Date September 6, 1977 Inspector //V
- * *NOTE; This system reviewed by Scarrow & Walker staff on Permit #336. This system is
IIII FINAL APPROVAL OF SYSTEM: identical to that system. Cy Cl,p „_Q
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 part.
it
l:// Septic Tank cleanout to within 12” of final grade or aerated access ports above grade.
O l ie Proper materials and assembly.
0.1 r e/ / 4 ie Trade name of septic tank ot aerated treat unit
e)'v Adequate absorption (or dispersal) area.
,04' Adequate compliance with permit requirements.
r / e Adequate compliance with County and State regulations /requirements.
Other
Date /
/ //7� Inspector- .a_�z� �:��'_ _
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 663.14 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,
__. :e t *� j h.'al :: '010011,' 111I ii h i� 111 {„ It y : : :,.,IIJ :1 0)m ::ll 5ry: illi ' :I :" :V
! ,, IAR 1 :e 11I : 'll : :0 '� ° I VV III 10::: glll„ : ,. I: d I'IP' h VIP Pb V' �' : ' _
II : '1'111 [1 V III:fI p �1 V 41" , I rr I : V II W II 1, ,1 4 II 1 11 1. i : : iy Pill � iul I. I r;,I' I u1pILI M I j� 1 'I�Ih, l 41dif : :IPPPr,,,r :d I�I'i9I IIII :: :rib, l 'il I�1 " II '
awm 111 I .1"ur 4)104011111 i4)104011111 w l... :i.0 :�1�1 Oki II :� : 4 0 11 / ,,, . d' 1 ,. ^ . � .,.._
ti ul^I A 1 P . 1 ' � ": it I x 101.1: 1 l : 1AM i d u��p yII IV : +r�.� ��I. �{ �I
II I :n on Id ID IPA., :I : I: I I P: o ,ry m : :" q°'!� : 1 tl i 'I V ' ofu l 1 0:
Fees Paid $;c
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date n l4 7
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: SD9ele-K (4. (SMl7H
Mail Address:/y 5744., 476, 4'�City: c NQ4Ler Zip: a /623;Phone: WaYa.
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW
Attach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable buildings, location of potable water wells, soil percola-
tion test holes, soil profiles in test holes.
1. Location of facility: County 4$*"32l/ ) City or Town
Legal Descriptior d boar, oviokle rc of Size 1. 02 4; +
2. No. of Bedrooms ,3 Septic Tank Capacity /2425 Aeration Unit Capacity _t
3. Source of Domestic Water: Public ( name): tJe5s7gpoit ga4,3 .w.t t vied Dlb72lC7
Private: Well Depth _ Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? N 0
5. Distance to nearest sewer system: 3 oa i t
Have you attempted to arrange a connection with the system? N d
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:
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.
/ 47int%
Date / Signature of Ap "cant
(TO BE RETURNED TO HEALTH DEPT.)