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HomeMy WebLinkAbout00910 This does not constitute 4 - a building or use permit. GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springs, Colorado 81601 Phone (3031,945-7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 010 Owner Jim Gravestock • System Location East Divide Creek Licensed Contractor * Conditional Construction approval is hereby granted for a / COD0 gallon Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate of one inch in 9C minutes requires a minimum of R 00 sq. ft. of absorption area per bedroom. Therefore the no. of bedrooms .3 x 3 00 sq. ft. minimum requirement = a total of 91) U sq. ft. of absorption area. �/ —7 May we suggest /2 x: S— x / C /e ep Q t /8 y X r� o A x 3 r C� � E' e /) / Date ` n / �f `�, D Inspector � 2�:(4 / ( :,;1/'ti",';;,(,-,:,t.- / FINAL APPROVAL OF SYSTEM:, C' I 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. pi Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground O A", surface. 1 ' \ Propeniaterials nd asser,�ply. c�,OP /ov+.t /woo / ' 1 � © Trade naf„e of septic to k or aerated tr tment unit , Ct_` �^ q 7 c J + Adequate absorption (or dispersal) area. C / X < //ed. a Adequate compliance with permit requirements. ` Adequate compliance with County and State regulations /requirements. • :/m e Date ! 0 3 / �7 Inspeoto RETAIN WITH RECEIPT RECORDS ' ONSTRUCTION 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 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 1, 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 $`7j ,0'b ,•- INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 40-10 - Owner: 777/v1 Goe /4"[ s7 Mail Addresss:: - 3 7 .0 / r City: _ 9J , 4/ Zip: e7652 Phonee76- 5 /S• INFORMA I 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 six-9'p/' CRe£k Legal Description72,6_,ws4 ZSoutA CMNrV /141Wi.ot Size O/JClIe-r `ot 7t'4e 4't" P'Ce#- cr, Metzzb /fit 2. No. of Bedrooms 3 Septic Tank Capacity /0 Aeration Unit Capacity 3. Source of Domestic Water: Public (name): Private: Well Depth Other Depth to 1st ground water table 30 4. Is facility within boundaries of a city /town or sanitation district? i 6 5. Distance to nearest sewer system: /t Have you attempted to arrange a connection with the system? /1p 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 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. Date S gnatur'q 'pp scant (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY / .' , d NousC 6 A 313 kit) nig('Alr,cfe'£K gtrio 31I 731 010 R1✓rR. --c/ /71 INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES Acets .1;4s74 Dir, ces K £11 rz •,.,r A • (TO BE RETURNED TO BLDG. & SANI. DEPT.)