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This does not constitute u ' I + i l '1 � I { i
. . • e a building or use permit. „pi tl„
I 081 GARFIELD COUNTY DEPARSIENT OF ENVIRONMENTAL HEALTH
2014 lake Avenue ,,1�'s
Glenwood $p ngs, Colorado 81601
Phone 303) 945-7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT Nct aE ^'
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Owner Gary Mayas
System Location 1103 Kl4141134 Avant. — G1.nwu4 4 ,1 ,;,i
Licensed Contractor
4
• Conditional Constructiop approval is hereby granted fora o gallon r, 49 I
/ Septic Tank or A erated treatment unit.:,
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in /0, minutes regquuires aa minimum of IZ*" sq. ft. of absorption area per badroom I F
Therefore the no. of bedrooms if x - �sq. "ft � minimum requirement a total of ..448_2sq. ft. of absorption area a +w
May wesuggest 4
/ Gtr dae /Kr/ x ' "' iy�."" �
Date ` 8 [, 1..3 / 9j ,` Inspector /8/t _/1 r - /, ,' '
l
FINAL APPROV OF SYSTEM: " ` � I — „, " r
No „mil n g any system
part shall be deemed to be in compliance with the Sewage covets"*, Disposal Laws until the assembled system is approved prior to cove 8 0
or septic 'fank access for inspection and cleaning within 12" of ground surface or aerated access ports above group . ,hill `'
surface. 7 r i t I
Proper materiels and assembly. �,,rr" 4, ,,
n` SC t. - 7 -- I $ '7 'J rade name of septic tank or aerated treatment unit . �"_ y 1-2 4 , -f_. „ r l
'Ip ri
8 0 / Adequate absorption (or dispersal) area.
10 8
e. /mot Adequate compliance with permit requirements. ,
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' Ad equate compliance with County and State regulations/requirements. x I 1I 4 9"
,
I Other
Date 44 4/ '.i_ -, / _ _ 41*-- „ill?' "
r f h ill 1
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
" "CONDITIONS: i t I
1. All installation must comply with all requirements of tie County Individual Sewage Disposal Regulations, adopted pursuant to al r II `I, _
m , thority'granted in 66.444, CRS 1963, amended 66.314] CRS 1963.
I ii
2. This permit is valid only for Connection to structures Which have fully complied with County and building requirements 8
Connection to or use with any dwelling or structures non approved by the Building and Zoning office shall automatically be a violax i dh_
tion of a requirement of the permit and cause for both Igal action and revocation of the permit.
3. Section ill, 3.24'requires any person who constructs, tars, or installs an individual sewage disposal system in a manner which in d '1 "
D volves a knowing and material variation from the term or specifications contained in the application of permit commits a Class (, i p w`aM
Petty Offense ($500.00 fine - 6 months in )ail or both). 8n I""
r
Building Official - Permit White Copy Applicant - Green Copy Dept. - Pink Copy 4 ` '�
Fees Paid $ 751°
INDIVII. SEWAGE DISPOSAL.SYSTEMS APPLOTION
Date (0--12.--)r
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
•
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: V e) /11Y aY 6)—C Mail Address: / /fji � �a City: ( 4 7 thoc. cL Zip: Phone:5 W9 •
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 facilit : Count 6 a Y P / City or Town v—,,,
i \DAA- - I p r �
Legal Descripti /to 5 nail Aid Au i Lot Size /7 �c +
2. No. of Bedrooms L,/ Septic Tank Capacity Aeration Unit Capacity
3. Source of Domestic Water: Public (name): ‘41 wool 9
Private: Well Depth Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? CAl gno
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system?
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: Sc.:- - t �
7. Name, address, and telephone of person who made soil absorption tests:
4c_ =Cal—Tea:tie
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.
"e
/ ate ,/97
'off Si ature of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
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CITY Or RECEIVED AU6 2 2 1977
CITY MANAGER GLENWOOE SPRINGS
John D. West
CITY ATTORNEY COLORADO
T. Peter Craven
DIRECTOR OF FINANCE
Robert M. West Jr. P.O. BOX 728, 81601
August 19,1977
Mr. Ed Feld
County Health Laboratory
2014 Blake Avenue
Glenwood Springs, Colorado
Dear Ed,
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Enclosed please find a c• -ey of the loc•tion of the septic
service requested by Mr. Ma es
In conversation Edith, City Manager, .. 4 ,ohn' b West, these two
septic service8`would be ecpeptable to"the"C,ity.
This permis i g n
is cpntint,rtupon Mr. •` ` Day reeing to connect to
the Citys ews`r� system:whe'i it is available \agree to annex
into the QS.ty7 of Gle w ' ngs l '1 )�
Thank you very 71iuch for your help. .and cooperati6h '' '_
Sincptel , ' " » y t Rte'
ir e
Mme'(
Robert M . West, ar. 1 °7 ..._.
Finance D]],,reo or ¢ , y „ g/7 i e ', I �r l
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