HomeMy WebLinkAbout00484 This does not constitute
a building or use permit.
St
[;. GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue \.
Glenwood Springs, Colorado 81601
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INDIVIDUAL SEWAGE DISPOSAL PERMIT ;� 484
Owner /t).? /.? .�fc Crt<.�cr�� r7"I 2./97
System Location 'S7 !7/-- /rf' /
Licensed Contractor _. ' L ice a
` Conditional Construction approval is hereby granted for a /f OC) gallon
)' Septic Tank or Aerated treatment unit.
Absorption area (or diapersal area) computed as follows:
Perc rate of one inch in .P5 minutes requires a minidium of -2.3 sq. ft. of absorption area per bedroom.
Therefore the no of bedrooms x 0-2.30 sq. ft minimum requirement = a total of 690 sq. ft of absorption area
May we suggest e"-- / -k .5 � A. 3 / SE"t ,3c - "79
Date //- 7 7 ,. Inspector
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FINAL APPROVAL OF SYSTEM: �Y
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.
✓ " Septic Tank cleanout to within 12" of fipal grade or aerated access ports above grade.
t"= Proper materials and assembly.
rY : Trade name of septic tank or aerated treatment unit z2`?"
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Adequate absorption. (or dispersal) area <
c:C r Adequate compliance with permit requirements.
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Adequate compliance with County and State regulations /requirements.
Other
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.
is 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 ling 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
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Fees Paid $75• -00
-- INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date // — : -77
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner:
Mail Address: (% �s7777 72-Cit ,?// Zip: 1/4c- ---=- /sre�
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW 60C ` 3 4(42
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 r�rz� City or Town , /.cc c=
Legal Description 00AV Sual Lot Size -549 /f - c- c -5 -f-
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2. No. of Bedrooms ;3 Septic lank Capacity 4 o nc, Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well X Depth Other Depth to first ground water tableu,✓,e.cA
4. Is facility within boundaries of a city /town or sanitation district? /c
5. Distance to nearest sewer system: 5.-2-7 , c e-1E>
Have you attempted to arrange a connection with the system? n/ c.
If rejected, what was the reason? e_/_57 r c
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: c c z /4 / 7
7. Name, address, and telephone of person who made soil absorption tests:
5c - , E r �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.
Ji / i
ii 7 - 77
Date Signa ! of t'.l icant
(TO BE RETURNED TO HEALTH DEPT.)
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_ PLEASE 'RAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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(TO BE RETURNED TO HEALTH DEPT.)