HomeMy WebLinkAbout00940 f
Jim This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
Phone (303) 945 -7255 •
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 940
Owner Ken Kri
System Location 0497 167 Road Glenwood Glenwood Springs, CO
Licensed Contractor .*kt r - e r. 7 e f..
• Conditional Construction approval is hereby granted for a /42,0 "'gallon
1 /Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows: /42,0 " ++ ����
Pere rate of one inch in /Q minutes requires a minimum of `4 • S sq. ft. of absorption area per bedroom.
Therefore the no. of bedrooms 3 x �(j' sq. ft. minimum requirement = a total of aq. ft. of absorption area.
May we suggest / x ' 3/ > // 4
Date >// / Inspector - 3 f„ { /1" ' tC 24il o ts .s •
V
FINAL APPROVAL OF SYSTEM: rf
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.
• ' i ■ ` Proper materials and assembly.
•
Sp 4'1? . r
i
• , • Trade erne e ` c to . or erratTeaf it.
Adequate absorption (or dispersal) area. t; > -l' ,
/�..:- X Z. (r"'R(
r - � Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
,..._. Other • 1
Date ,' ` / �'' Inspector Q/4,4 . t J N 12 fry?. ,1
RETAIN WITH RECEIPT RECORDS 6T 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 10gal 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 V V'U
Pa
g Fees Paid $j
•
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date
•
Owner: ��( Aip/en
Mail Address: Q111f7- l #7 if, City: 4 a " /pd400 c_+t_Zip: L Phone: f -A`7ot
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW I'
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). -
Near What //
1. Location of Facility: County GARFIELD City or Town eenvw494P / `
a r
Location Address & /or
Legal Description Oyp7 _ / / 7A7 Lot Size / r"( jprAna,eox_
2. No. of Bedrooms f' Septic Tank Capacity Mid Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well !/ Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? ,4/j
5. Distance to nearest sewer system: C/,yy
Have you attempted to arrange a connection with the system? ,4',
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:
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.
I Z - ` � - O �-�
6 ,
Date i gnature o Appl ( t
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
W s —+ PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
A
Mfg 'erne •
I
1
y
4119y -AM, pt s
•
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LIN S, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
G78, _
fitic
for
m �lss
o
l - X9¢.36'
(TO BE RETURNED TO BLDG. & SANI. DEPT.)