HomeMy WebLinkAbout00569 7 , -. _... _ - .-... - __. .. _....
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i f 0 This does not constitute ,
a building or use permit.
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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
21214010k° Avenue
Glenwood Spr 30 3 ings Colorado 81601
Phone ) 945-7265
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 l eigg °W
Owner Xittu C. Bromley
System Location 74 alloy S. of New testis (old School house) County Road 312
Licensed Contractor i ' - 'MI
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• Conditional Construction approval Is hereby granted for e "%CO gallon
Septic Tank or Aerated treatment Unit.
Absorption area (or dispersal area) computed as follows: 6
m' il
Petc rate of one inch in -00 minutes requires a minimum of vZ /A sq. ft. of absorption area per bedroom. i h 'tit "
Therefore the no. of bedrooms _a a x t0 sq. ft, minimum requ�i ' rement ■ p total of 4 ' sq. ft. of absorption sr* I '' I1II4)1 "' m
' May we suggest . ,r�.r^ +1,¢ � 1 ) '�+ 3 � J ` � r ' a...
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Date , c , '`, e // /7 7/ - I nspector � L' z" ail. al:L`. .<
FINAL APPROVAL OF SYSTEM:
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II No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is appu ed prior to cover
ing any part. .
rOse----- Septic Tank access for inspection and cleaning within 12 of ground surface or aerated access ° I ports above ground
11 surface.
Proper materials and assembly.
lJ rade name ofseptic tank or aerated treatment unit. t / �sl... s ? r„.e. ,
If
ear' Adequate absorption (or dispersal) area.
III 01 Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
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Other "ka
Date //� �..� - (�J Inspector f�� /A 447 —P leC
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE '
w "CONDITIONS: •
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to aW
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.
u is S Section III, 124 requires any person who constructs, alters, or installs an individual sewage dikpo ;al system in a manner which in-
volves a knowing and material variation from the terms or specifications contained in the application of permit commits e Class 1,
!tie , Petty Offense ($500.00 fine — 6 months in jail or both). , ,
Building Official — Permit White Copy Applicant — Green Copy Dept, • — Pink Copy
. Fees Paid $�,'
INDIVIDUAL SEWAGE DISPOSAL. SYSTEMS APPLICATION
Date 642-1
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT.SYSTEM
•
Owner: I'K ,►2 ny C. 8►2o rA Lty
Mail Address: 1309, I2q •Pry -4 4 City: C`LEi, j&jn Zip: RIG,oI Phone: 945 - 977/
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 Garfield City or Town /JEW CJAS T L 8
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cw...6* f oV,1_&6 tlaeu¢q ' 4 a .* N U Yge6Ssc.3 a a
,T. (,.etw (4- P.M.•
Legal Description 7 ?mules S ,Cogc.... y f9n 31a Lot Size 7 1QES
2. No. of Bedrooms a Septic Tank Capacity--)S—C) Aeration Unit Capacity
3. Source of Domestic Water: Public (name): WELL
Private: Well tg Depth A& Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? WO
5. Distance to nearest sewer system: NA
Have you attempted to arrange a connect on with the system? PA
If rejected, what was the reason? N
6. Rate of absorption in test holes show on the location map, in mirnites 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 t ts:
4 P 8. Name, address, and telephone of person responsible for design of he 12?-a—
tem:
9. Express permission is hereby granted for the inspection of the abov 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.
L -l2-7 a
Date S ture of Ap icant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW 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, ROA', AYS, AND BOUNDARY LINES
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(TO BE RETURVED TO HEALTH DEPT.)