HomeMy WebLinkAbout00773 • This does not constitute ' 1 l el
a building or use permit
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs Colorado 81601
Phone 4303) 945-7265
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9
III 4
Owner L. V. IiNk*KUIN Christensen 4 ,u,
System, Location Silt //,rg S a Co � RcL t /� , , S r/>� - . i '
Licensed Contractor (74(Jtf t /- «" `
' Conditional Construction approval is hereby granted for a /1/2 a0 e9 gallon r f.
v Septic Tank or Aerated treatment unit. i, e
Absorption area (or dispersal area) computed as follows: �.
. Parc rate of one inch in (p 0 minutes requires a minimum of '? 30 sq. ft of absorption area per bedroom. , i. u l° ^
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Therefore the no. of bedrooms 3 x .�S�sq. ft, minimum re / � a total � sgoft � r � 7 . �
May we suggest :.?'�. 9 t 0 3 # X w ICJ' Cr - z- d2 �n /� `'''� r "\ ' rl M t I :�'
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Date y X 3 �' . .� / / y 7 Inspector . y r? 2 ,Q 2' i 00 Vii 1 1
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FINAL APPROVAL OF SYSTEM: 4 I r,
11 ri r
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover is r
ing any part,
dip 0lr Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground I }
surface.
011 Proper materials and assembly. 1
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I; i�/ Trade name of septic or aerated I treatment unit.
Il.. On Adequate absorption (or dispersal) area. _ I, o
C9k Adequate compliance with permit requirements.
07k • Adequate compliance with County and State regulations /requirements. 1 q
it .----- Other —
Date / 2/x/77 Inspector V/ /094147...---
ii i
/ RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1 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 111, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner Which ins I
volves a knowing and material variation from the Omit or specifications contained in the application of permit commits a Class 1, " I,
Petty Offense (5600.00 fine - 6 months in jail or both):
1
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I Building Official — Permit White Copy Applicant — Green Copy Dept. — Pink Copy
tau eta AA LA islidtk —
LTTICe use
Page Two Fees Paid $1S
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date ( 7-7)0 : ) ( i
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Owner: 2 . d . r %r. x �F• .v--
Mail Address: /01 79 - all 4/ Ci ty .Si l7 Zip: Phone: 87 �7j
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 (see Page 3).
1 . Location of Facility: County GARFIELD City or Town 5 , 0
Legal Description s / j/ '. 4 , ' Lot Size 20 4e.rca.
2. No. of Bedrooms 3 Septic Tank. Capacity J m o o Aeration Unit Capacity
3. Source of Domestic Water: Public (name): w //
Private: Well . < Depth ?n&/ 1 Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? n/n
5. Distance to nearest sewer system: /V IX
Have you attempted to arrange a connection with the system?
If rejected, what was the reason?
6. If R.P.E. tested, state 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:
7. Name, address, and telephone of R.P.E. who made soil absorption tests:
8. Name, address, and telephone of R.P.E. responsible for design of the system:
g. Express permission is hereby granted for the inspection of the above property by any
member of the Garfield County Building & Sanitation Department and /or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Building & Sanitation Department.
10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula-
tions of Garfield County and I hereby agree to comply with all terms, conditions and
requirements included therein.
q -ao-nDa e' Igna ure o 'pp scant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
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