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This does not constitute
♦ a building or use permit.
• sr- GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
` Glenwood Springs, Colorado 81601
PERC WAIVED - RATS KNOWN - FES ONLY 1�� Phone (303) 945-7255
NI&JJ — AL SWAGE DISPOSAL PERMIT N i? 552 11
Owner r e and Eleanor Z. Kentze e11s_.-
System Location rot 8, Oak Meadows, $rd Filing
Licensed Contractor
•
• Conditional Construction approval is hereby granted for a __7•57 gallon r» in// ti iy)
X Septic Tank or Aerated treatment unit. RES PERMIT #402 FOR MC
Ili , Absorption area (or dispersal area) computed as follows: ( Tha"' , w '"
Perc rate of one inch in %S minutes requires a minimum of -_ sq. ft. of absorption area per bedroom.
(5-16 -l1)
Therefore the no. of bedrooms _ xat:::2 sq. ft. minimum requirement = a total of 6200q ft of absorption area.
May we suggest / -- X .sr tic 5 ' � 'S n• = /9077 /
Date , � �.. /�. •.- ') Q'� � Insp c� for ��1"7`•'. "i %� / (,
G
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembl$'flvst6r isiepproved pri r to cover-
ing any part.
0/e Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above g ound
surface.
(� �✓ Proper materials and assembly. -
L ,l/ c .
Trade name of septic tank .r aerated treatment unit.
C/e Adequate absorption (or dispersal) area.
•
n /6 Adequate compliance with permit requirements.
tic Adequate compliance with County and State regulations /requirements.
Other •
Date ei 9 /9,7, 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. I4 ,
Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatioalljY.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 term or specifications contained in the application of permit commits a Class I,
Petty Offense ($500.00 fine - 6 months in jail or both).
4
a Brlildi e f i ial - Permit White C o p y u Applicant - Green Copy w f) .Pink Cop d wn , ; a -
�'�a�ILai aw...11 J,v:Gwuu.url�w..u_ tiWL.' Wr�kr, ult iu. i" i,: J4Lwr�w�I. rYL. irr. wli, r` YuwieiutsaiC� 'awrrrr�wWrw'— �'�� - - --
Fees Paid 05 -
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date 5
.
• NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE y
INDIVIDUAL HOME SEWAGE TREATMENT.SYSTEM Coi Rt&nnr
44 10
Owner: Q. ' ` f2 reiLlA.
44 S 1 Z
Mail Address. u
2 6 , City: t 'y.1/`, Zip: Phone: y+�
INFORMATION REGARDING PROJECT SUBMITTED FOR RENEW
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 Garfield City or Town
Legal Description k2 . kAabi(le, 1144, * me Lot Size 5+ Ot,,.U4 -
2. No. of Bedrooms '�_ Septic Tank Capacity V Aeration Unit Capacity
3. Source of Domestic Water: Public (name):
Private: Well Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system: 1,114
Have you attempted to arrange a connection with the system? 444(Q ((,(fa
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in iq�inu es• er c ct
drop in water level after holes have been soaked for 24 hours :Ira, `p
7. Name, address, and telephone of person who made soil absorption tests:
CT � tic La 6-04-.
8. Name, address, and telephone of person responsible for design of the system:
�t-
e re " h Atka_ zavt.v.a.az
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.
►. D (te ( I " Signature � 1 ant
Y
(TO BE RETURNED TO HEALTH DEPT.)