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HomeMy WebLinkAbout00576 This does not constitute a building or use permit. GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 8 D ONLY_ Phone (3031 945.7255 MC FS WAli'k RA4B' KpOMN FSS INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 576 ' Owner Dennis J. Edson System Location rat 20, riling 2. itiMatbank Licensed Contractor ie * Conditional Construction approval is hereby granted for 1,000 gallon Septic Tank or X Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in minutes requires a minimum of 125 sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms x sq. ft. minimum requirement = a total of 375 sq. ft. of absorption area. May we suggest Deep Field 10' square a 12' deep, Date June 16, 1978 Inspector • /-\\* FINAL APPROVAL OF SYSTEM: ^ O ) ^^ "` ~° ic w/ No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved rior to cover- ing any part. C - Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. fit-_.- Proper materials and assembly. ■c 7 Trade name of septic tank or aerated treatment unit. 0..■e -- Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. ter-- Adequate compliance with County and State regulations /requirements. Other Date r_f� lFC' 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 / Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viol/ 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, orinstalls an individual sewage disposal system in a manner which volves a knowing and material variation from the terms or specifications dontained in the application of permit commits a CI,/ Petty Offense ($500.00 fine — 6 months in jail or both). Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy ,. Fees Paid $0t INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION ( l � �� Date o - n- NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE '() INDIVIDUAL HOME SEWAGE TREATMENT.SYSTEM Owner: br n# s 9 fJsea -- Mail Address: /Tor 771 City: 4,,j Zip: SA'? 3 Phone: 963 3/3' 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 q, Legal Description /rr-t 20 A14: Z. leA,A44kLot Size / 2. No. of Bedrooms 3 Septic Tank Capacity Aeration Unit Capacity /, pa'a 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? /y 5. Distance to nearest sewer system: S .ri. Have you attempted to arrange a connection with the system? /5/ If rejected, what was the reason? IK Rate of absorption in test holes shown on the location map, in minutes per inch of r drop in water level after holes have been soaked for 24 hours: Name, address, and telephone of person who made soil absorption tests: 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. i/ oats "Signature of Applicant (TO BE RETURNED TO HEALTH DEPT.)