HomeMy WebLinkAbout00902 h s This does not constitute
it a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 lake Avenue
Glenwood $0 ngs, Colorado 61601 .
Phone 303) 9454256
•
INDIVIDUAL SEWAGE DISPOSAL PERMIT N? 902
Owner , ';11111 R. Stoddard 902
System Location 2575 County Ro 115
Licensed Contractor
Conditional Construction approval is hereby granted ford 7'C gallon
1 V Septic Tank or Aerated treatment unit. .
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in / minutes requires a minimum of /4 sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms -i ir
x �r S sq. ft, minimum requirement = a total of 'S 3 ° q. ft. of absorption area.
May we suggest / h
2 ' 2 ,K -5 r 1 c; E'p.
Date I , � % ii 4 ) Inspector /, 'z ✓Qt -, / � 1 71,7—‘4444--) / '
FINAL APPROVAL OF SYSTEM: �' t ..
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover-
ing any part.
D PC Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
D K surface.
Proper materials and asse bly. 9-
r `
an i /000 r a j i
✓� Trade na e o s eptic to k.or aerate reatmentunit.
0 V Adequate absorption (or dispersal) area. 1 •
0 f/• . Adequate compliance with permit requirements.
U i Adequate compliance with County and State regulations /requirements.
—...
Other
if Date / ///'' ?� /ik " Inspector / . - _ ` 1 - �- -
l / RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE /
*CONDITIONS: .
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-;
thority granted in 66 -44 -4, CRS 1963, amended 66- 3- 14,1CR$ 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
Page Two Fees Paid 9S
• INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 7 - Zi•- X U
if c------~
Owner: , P--
Mail Address: 25 S //S City: G --4 ZiperSc, Phone:
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 ( 9
{ size to r1&\ City or Town - c_/V/
Legal Description IA/ Le T - 'y SF _ c... - 1.=k 1
2. No. of Bedrooms 2— Septic Tank Capacity ( 096 Aeration Unit Capacity
3. Source of Domes is Water: Public (name):
Private: Wei C► .4 Depth Other Depth to 1st ground water table
4. Is facility ithin boundaries of a city /town or sanitation district? /l/O
Ai
/A
Distance to nearest sewer system: / IO
Have you attempted to arrange a connection with the stem? d
If rejected, what was the reason? /(/ 4
6. If R.P.E. tested, state rate of absorption in to t 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:
9. 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.
aillig a1,! I at_ LAP
late igna ure o App scan
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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5 20 sb
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
(TO BE RETURNED TO BLDG. & SANI. DEPT.)