HomeMy WebLinkAbout00478 - a+
Rr .,, t.R.tian
+ s This does not constitute
i I a building or use permit.
GARFIELD COUNTY DEP/)j v1ENT OF ENVIRONMENTAL HEALTH 1 mmr
2014 Blake Avenue
'ki, Glenwood SPrings, Colorado 81601
INDIVIDUAL SEWAGE DISPOSAL PERMIT NY i 478
Owner Gine Byrne
System Location County Road 265 - R1fie I l
Licensed Contractor en , i n. .4 .
Conditional Construction approval is hereby granted for S ..„4,...ceiCt. gallon
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Septic Tank or Aerated treatment i4nit.
Absorption area (or diapersal area) computed as follows:
Pero rate of one inch in ! minutes requires a minirbum of _'+3 r•• sq. ft. of absorption area per bedroom.
Therefore the no of bedrooms 3 x .. sq. ft minimum requirement = a total of'QL4q. ft, of absorption area
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May we suggest /.?' '
X Sr x 3 . n 'ntoar 43 a�J. ,,�,d�� , ,
Date /i -- 4'77 Inspector j J � "7i� —
+FINAL APPROVAL OF SYSTEM: • •• °,
III 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. : ,,44/ . -
/ "ir— Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
` 22– Proper materials and assembly. .
11 � rade na e'or aerated tre unit.
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�//'' Adequate absorption (or dispersal) area
I ‘ � Adequate mp p requirements. compliance with permit
'� /�� Adequate o with Count and St ate regulations /requirement / - , –
Other
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Date /7 '--- 7 2 N 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-
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thority granted in 66.444, CRS 1963, amended 66.3.141 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 n t approved by the building and Zoning office shall automatically be a viola-
tion of a requirement of the permit and cause for both gal action and revocation of the permit.
1 Section III, 124 requires any person who constructs, 4 tern, or installs an individual sewage disposal system in a manner which in. if
volves a knowing and material variation from the term$ or specifications contained in the application of permit commits a Class I,'
11111 ` Petty Offense ($500.00 fine – 6 months in jail or both,
III Building Official – Permit White Copy Applicant – Green Copy Dept. – Pink Copy
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• Fees Paid $cam
e 1' J . INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date ih -c 11
v e NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: (ceh e 13)/Ppee
Mail Address: d3o 3 NE /1o04 City e e.(n_ Zip: )76,P0 U Phone: (;
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 (^ii) 4''ea City or Town / *, /e 0 €J, h- Rd'h
Legal Description pie /ii Lot Size 2 ard'e5
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2. No. of Bedrooms ' Septic Tank Capacity 4 v - ration Unit Capacity
3. Source of Domestic Water: Public (name): (',^/Y 6-1(' Th -/'/F.
Private: Well ,q ,..Q_ Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? Nn
5. Distance to nearest sewer system: 1 /v 0/,le
Have you attempted to arrange a connection with the system? Y.(
If rejected, what was the reason? Aso 4, ekua, al 17a"ec) 7
6. Rate of absorption in test holes shown on the location map, in mina es 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 tes s:
.C 4_14 .1
8. Name, address, and telephone of person responsible for design of t system: ______ 0
9. Express permission is hereby granted for the inspection of the / above p ot` 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.
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.
) , 7# /99 /99 9 JJ S gna 2 of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
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