HomeMy WebLinkAbout00698 This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
rVl ull. Glenwood Springs, Colorado 81601
Phone 0 303) 945.7255
1' DIVIDUAL SEWAGE DISPOSAL PERMIT NO 6�
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Owner .7caaas H Arrsff f
'System Location Glenwood Springs
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Licensed Contractor '
Conditional Construction approval is hereby granted for a 7r gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows: �!
Perc rate of one inch in, ,j ' c2 minutes requires a minimum of Z sq. ft of absorption area per bedroom.
Therefore the no. of bedrooms x , l st) sq. ft. minimum requirement = a total of . .Cvp sq, ft. of absorption area.
May we suggest %$r/ /�c C. /� / X %7 Z �-' A „ e
Date r
.r...c .7 / f 27 Inspector ; /? C.-t.l��i 1 - 7-,r. _.
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FINAL APPRbVAL O SYSTEM:
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 access for inspection and cleaning within 12" of ground surface or aerated access ports above ground '
surface.
Proper materials and assembly.
1, OO ,
G.RAAIDf Trade name of septic tank or aerated treatment unit.
tOr Adequate absorption (or dispersal) area.
/t Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
Other ,
Date /?t /�7 Inspector a RETAIN WITH RECEIPT RECORDS A CONSTRUCTIOE
*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 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
/ Fees Paid $7S rr,
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS APPLICATION
Date
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM
Owner: Y11 R. • t MRS. . )fv nES fM57
Mail Address: (30K i5q(o City: ec.& SPgs Zip: r7(p0/ Phone: f 5768
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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 6?
.JrC? 2—o 4 z. 7 <C7 T/ Cc 2 e> i c U 7 s
Legal Description tri y gF ' y nc= / , e ) Lot Size Sstcees
2. No. of Bedrooms a- Septic Tank Capacity iO4»Acs. AeratiRp,,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? No
5. Distance to nearest sewer system: rn ,' t
Have you attempted to arrange a connection with the system? ,Yc2
If rejected, what was the reason? /
,8 Rate of absorption in test holes shown on the location map, in minutey'per inch of .
drop in water level after holes have been soaked for 24 hours:
..J Name, address, and telephone of person who made soil absorption tests:
-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.
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— cr" 7 ifriALES 4
Date Signature of Applicant
(TO BE RETURNED TO HEALTH DEPT.)
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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Tu ON I I S 2o4t — opposeTE Pri -t0 VVa -t - o fade
3,1 nA . 1 aith t'r F . 1.410k er r5 50O 8_,4nos dow-i
1010 s,AN
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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Access 404k0
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(TO BE RETURNED TO HEALTH •.PT.)